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1912538638
KATHLEEN A TYLER
PORT JEFFERSON, NY
NPI
1912538638
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY 047068)
Enumeration Date
2020-01-31
Last Update Date
2020-02-26
Business Address
KATHLEEN A TYLER LCSW
1401 MAIN ST
PORT JEFFERSON, NY 11777-2225
Phone number: 631-928-0202
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Mailing Address
KATHLEEN A TYLER LCSW
1401 MAIN ST
PORT JEFFERSON, NY 11777-2225
Phone number: 631-928-0202
Copy
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