Organization
TY B. ALLER, LMFT, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TY ALLER LMFT (PRESIDENT)
(385) 200-3993
Entity
Organization
Contact information
Practice address
545 W 465 N STE 130, PROVIDENCE, UT 84332-8005
(385) 200-3993
Mailing address
PO BOX 583, PROVIDENCE, UT 84332-0583
(385) 200-3993
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/31/2018
Last updated
10/31/2018
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