Individual
SUSAN CAROL TYLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
60 W SUNBRIDGE DR, FAYETTEVILLE, AR 72703-1822
(479) 695-1240
(479) 750-4843
Mailing address
2400 S. 48TH STREET, SPRINGDALE, AR 72762
(479) 750-2020
(479) 750-4843
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
2393-M
AR
1041C0700X
Clinical Social Worker
Primary
2674-C
AR
Other
Enumeration date
07/14/2009
Last updated
05/25/2016
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