Individual
TYLER STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCMHC
Contact information
Practice address
11075 S STATE ST STE 16, SANDY, UT 84070-5196
(801) 948-0939
Mailing address
11075 S STATE ST STE 16, SANDY, UT 84070-5196
(801) 948-0939
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8598755-6004
UT
Other
Enumeration date
06/20/2016
Last updated
06/20/2016
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