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General NPI Number Information
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NPI Number | 1265770879
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Entity Type | Individual
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Provider Name | TYLER D STAPLES PSYD
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Gender | Male
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Dates
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Enumeration Date | 01/17/2013
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 25055 W VALLEY PKWY STE 220
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City | OLATHE
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State | KS
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Zip | 66061-8450
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Country | US
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Telephone | 913-378-1061
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Fax |
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Provider Business Mailing Address
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Address Line | 8456 MAURER RD APT. 837
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City | LENEXA
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State | KS
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Zip | 66219-2736
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Country | US
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Telephone | 913-269-9621
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 03275T
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License Number State | KS
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