Individual
TYLER ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1039 W MASON ST, GREEN BAY, WI 54303-1842
(920) 965-7707
Mailing address
3031 BAY VIEW DR, GREEN BAY, WI 54311-5907
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5914
WI
Other
Enumeration date
01/11/2016
Last updated
01/11/2016
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