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Individual

TYLER ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CSW

Contact information

Practice address
1515 N 400 E STE 104, LOGAN, UT 84341-7595
(208) 232-7862
Mailing address
500 S 11TH AVE STE 400, POCATELLO, ID 83201-4880
(208) 232-7862

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
14225907-3502
UT

Other

Enumeration date
06/10/2025
Last updated
06/10/2025
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