Tyler Stark, LCMHC

NPI #1598115669 in Sandy, Utah

Provider Information

NPI Number: 1598115669
Entity Type: Individual
Name: Tyler Stark, LCMHC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Professional
Credential: LCMHC
Enumeration Date: Jun 20, 2016
Last Updated: Jun 20, 2016

Practice Location

Address: 11075 S STATE ST STE 16
City: Sandy
State: Utah
ZIP Code: 84070-5196
Phone: (801) 948-0939

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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