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Individual

MRS. SUSAN CHANDLER TYLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CBS, DIPLOMATE, CNC

Contact information

Practice address
268 NEW BRIDGE RD, GLIDE, OR 97443-9609
(541) 733-4207
(888) 629-4949
Mailing address
268 NEW BRIDGE RD, GLIDE, OR 97443-9609
(541) 733-4207
(888) 629-4949

Taxonomy

Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
CERTIFICATION ONLY
CA
174400000X
Specialist
Primary
CERTIFICATE 3592 DQT
NC
174400000X
Specialist
CERTIFICATE 3592 QBS
NC
174400000X
Specialist
SHC 1073
NC

Other

Enumeration date
10/14/2009
Last updated
10/14/2009
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