Doctor Name: | MS. TYLER B COLEMAN |
NPI Number: | 1184781221 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, LCPC, LAC |
License Number: | 664 |
Business Practice Address: | 115 W 3rd St Suite 107 Stevensville, MT - 598702038 |
Business Phone Number: | 4063965910 |
Business Fax Number: | |
Mailing Address: | 1107 Lincolnwood Rd, MISSOULA |
State: | MT |
Postal Code: | 598023037 |
Phone Number: | 4063965910 |
Fax Number: | |
NPI Enumeration Date: | 01/01/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 664 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |