Individual
DR. TYLER MAXWELL DORITY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LP
Contact information
Practice address
12 CIVIC CENTER PLZ STE 1615, MANKATO, MN 56001-7783
(507) 345-4679
Mailing address
12 CIVIC CENTER PLZ STE 1615, MANKATO, MN 56001-7783
(507) 345-4679
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP6328
MN
103TC1900X
Counseling Psychologist
LP6328
MN
103TF0200X
Forensic Psychologist
LP6328
MN
Other
Enumeration date
11/06/2018
Last updated
08/02/2022
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