MEDICARE: TYLER CAZIER

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
1	101YP2500X	Professional Counselor	LCPC-8601	ID

General Provider Information

NPI Number	:	1639575921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYLER CAZIER

Provider Business Mailing Address
First Line	:	3061 S MERIDIAN RD STE 100
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-7962
Country	:	US
Telephone Number	:	208-461-8024
Fax Number	:

Provider Business Practice Location Address
First Line	:	3061 S MERIDIAN RD STE 100
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83642-7962
Country	:	US
Telephone Number	:	208-461-8024
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2014
Last Update Date	:	03/22/2024

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Directions to “ TYLER CAZIER ” Practice Location

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