Individual
TYLER YOUNG QUATTLEBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
19 E MOUNTAIN ST STE 1, FAYETTEVILLE, AR 72701-6067
(479) 381-0831
Mailing address
19 E MOUNTAIN ST STE 1, FAYETTEVILLE, AR 72701-6067
(479) 381-0831
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P2210005
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P2210005
ARKANSAS BOARD OF EXAMINERS IN COUNSELING AND MARRIAGE & FAMILY THERAPY
AR
Enumeration date
04/30/2018
Last updated
10/10/2022
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