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Individual
TYLER LOUIS MARTIN
Active
Individual
TYLER LOUIS MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
14064
TX
1041C0700X
Clinical Social Worker
Primary
107840
TX
1041C0700X
Clinical Social Worker
C011404
NC
Other
Enumeration date
04/17/2018
Last updated
06/14/2024
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