Individual ProviderTyra WilliamsBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address17106 Cleveland Rd, South Bend, IN 46635-1414(574) 855-4292PECOS EnrollmentBased on the most recent information from CMS, provider Tyra Williams does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:33 PM.Profile DetailsProvider ID1962385070Provider TypeIndividualFull NameWilliams, TyraGenderFemaleSole ProprietorNoEnumeration Date7/28/2025Last Updated7/28/2025Contact InformationPractice LocationPractice Address17106 Cleveland Rd, South Bend, IN 46635-1414Phone(574) 855-4292FaxUnlisted FaxMailing LocationMailing Address17106 Cleveland Rd, South Bend, IN 46635-1414Phone(574) 855-4292FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer