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Individual
DR. TYLER FORTMAN
Active
Individual
DR. TYLER FORTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071008865
IL
103TC0700X
Clinical Psychologist
0810004806
VA
Other
Enumeration date
05/14/2014
Last updated
02/14/2017
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