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General NPI Number Information
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NPI Number | 1407305642
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Entity Type | Individual
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Provider Name | TYLER STEPHENS
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Gender | Male
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Dates
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Enumeration Date | 09/29/2016
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Last Update Date | 02/08/2017
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Provider Practice Location Address
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Address Line | 608 HAPPY VALLEY RD
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City | GLASGOW
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State | KY
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Zip | 42141-1561
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Country | US
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Telephone | 270-901-5000
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Fax | 270-842-5268
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Provider Business Mailing Address
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Address Line | 608 HAPPY VALLEY RD
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City | GLASGOW
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State | KY
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Zip | 42141-1561
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Country | US
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Telephone | 270-901-5000
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Fax | 270-842-5268
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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 | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number |
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License Number State |
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