Individual
MR. TYLER SCOTT HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ASUDC
Contact information
Practice address
996 W 800 S, PAYSON, UT 84651-2766
(801) 465-5111
(801) 465-7762
Mailing address
996 W 800 S, PAYSON, UT 84651-2766
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10393114-6018
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10393114-6018
CERTIFIED ADVANCED SUBSTANCE USE DISORDER COUNSELOR
UT
Enumeration date
10/23/2018
Last updated
10/23/2018
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