Patrick, Tyler

Patrick, Tyler is an sole proprietor health care provider with primary practice located at 40 West 1250 North 3C, Logan UT 84341. He recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as his primary health care specialty. Patrick, Tyler can be contacted via phone (208) 351-9687.

Contact Information

Primary practice address
40 West 1250 North 3C Logan UT 84341
Phone: (208) 351-9687
Fax: (208) 356-4703
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X MFTI-3914 Idaho
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 7997802-3902 Utah

Profile Details

NPI number 1225214828
LBN Legal business name Patrick, Tyler
Credentials LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 14th, 2008
Last updated May 5th, 2020 - about 5 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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Identifiers

StateTypeNumberIssuer
All States NPI 1225214828 NPPES
Idaho MEDICAID 807372200

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