Doctor Name: | TYLER WHITTAKER |
NPI Number: | 1396110615 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 2860 E 19500 N Moroni, UT - 84646 |
Business Phone Number: | 4354369029 |
Business Fax Number: | 4354369027 |
Mailing Address: | Po Box 461, MORONI |
State: | UT |
Postal Code: | 846460461 |
Phone Number: | 4354455200 |
Fax Number: | 4354455201 |
NPI Enumeration Date: | 12/11/2015 |
NPI Last Update Date: | 12/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |