| Doctor Name: | KRISTIE LEESHAWN TYLER |
| NPI Number: | 1255583456 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC, NCC |
| License Number: | LPC-13082 |
| Business Practice Address: | 438 West Skill Center Road Sacaton, AZ - 852470038 |
| Business Phone Number: | 6025287143 |
| Business Fax Number: | 6025281374 |
| Mailing Address: | Po Box 38, SACATON |
| State: | AZ |
| Postal Code: | 852470038 |
| Phone Number: | 6025287143 |
| Fax Number: | 6025281374 |
| NPI Enumeration Date: | 10/21/2008 |
| NPI Last Update Date: | 10/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LPC-13082 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |