Individual
MS. TYLER B COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LCPC, LAC
Contact information
Practice address
2825 STOCKYARD RD STE A22, MISSOULA, MT 59808-1546
(406) 396-5910
Mailing address
1107 LINCOLNWOOD RD, MISSOULA, MT 59802-3037
(406) 396-5910
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
664
MT
101YP2500X
Professional Counselor
Primary
1041
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0256880
—
MT
01
—
742530
BLUECROSS BLUESHIELD
MT
Enumeration date
01/01/2007
Last updated
06/06/2024
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