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NPI Code Detail

MEDICARE: TAYLIN TYLER

MEDICARE: TAYLIN 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
1101YA0400XAddiction (Substance Use Disorder) Counselor0734007944VA
2101YA0400XAddiction (Substance Use Disorder) Counselor0709025588VA

General Provider Information

NPI Number : 1740925890
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLIN TYLER
Provider Business Mailing Address
First Line : 4600 MONTGOMERY RD STE 400
Second Line :
City : CINCINNATI
State : OH
Zip : 45212-2600
Country : US
Telephone Number : 833-510-4357
Fax Number : 866-460-2997
Provider Business Practice Location Address
First Line : 4140 CROSSINGS CT STE 101-103
Second Line :
City : PRINCE GEORGE
State : VA
Zip : 23875-1538
Country : US
Telephone Number : 833-510-4357
Fax Number : 866-460-2997
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2022
Last Update Date : 06/18/2024

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Directions to “ TAYLIN TYLER ” Practice Location

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