Individual
TYLER J GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CMHC
Contact information
Practice address
750 RIDGEVIEW DR STE 104, ST GEORGE, UT 84770-2696
(801) 822-2407
Mailing address
750 RIDGEVIEW DR STE 104, ST GEORGE, UT 84770-2696
(801) 822-2407
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
109774493-6004
UT
101YM0800X
Mental Health Counselor
10977493-6009
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82-1067031
SOLE PROPRIETOR BUSINESS
UT
Enumeration date
10/18/2018
Last updated
12/09/2024
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