Dority, Tyler Maxwell

Dority, Tyler Maxwell is an sole proprietor health care provider with primary practice located at 12 Civic Center Plz Ste 1615 , Mankato MN 56001-7783. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Dority, Tyler Maxwell can be contacted via phone (507) 345-4679.

Contact Information

Primary practice address
12 Civic Center Plz Ste 1615 Mankato MN 56001-7783
Phone: (507) 345-4679
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counseling 103TC1900X LP6328 Minnesota
Behavioral Health & Social Service Providers / Forensic 103TF0200X LP6328 Minnesota
Behavioral Health & Social Service Providers / Clinical 103TC0700X LP6328 Minnesota

Profile Details

NPI number 1104394212
LBN Legal business name Dority, Tyler Maxwell
Credentials PHD, LP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 6th, 2018
Last updated Aug 2nd, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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