Healthcare Provider Details

I. General information

NPI: 1982534442
Provider Name (Legal Business Name): TYLAR O'NEAL LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WRIGHT STATE UNIVERSITY
DAYTON OH
45435-0001
US

IV. Provider business mailing address

6325 GANDER RD E
HUBER HEIGHTS OH
45424-4171
US

V. Phone/Fax

Practice location:
  • Phone: 937-775-3801
  • Fax:
Mailing address:
  • Phone: 937-694-4686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.2208545
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: