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NPI Code Detail

MEDICARE: MARION TYLER

MEDICARE: MARION TYLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1346624350
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARION TYLER
Provider Business Mailing Address
First Line : 4780 I 55 N STE 105
Second Line :
City : JACKSON
State : MS
Zip : 39211-5542
Country : US
Telephone Number : 601-956-4816
Fax Number : 601-956-4817
Provider Business Practice Location Address
First Line : 4780 I 55 N STE 105
Second Line :
City : JACKSON
State : MS
Zip : 39211-5542
Country : US
Telephone Number : 601-956-4816
Fax Number : 601-956-4817
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2015
Last Update Date : 02/02/2022

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Directions to “ MARION TYLER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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