Individual
KEENAN TYLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
956 IRON BRIDGE DR, VIRGINIA BEACH, VA 23462-4655
(757) 660-8459
Mailing address
956 IRON BRIDGE DR, VIRGINIA BEACH, VA 23462-4655
(757) 218-1279
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0701012951
VA
101YP2500X
Professional Counselor
Primary
0701012951
VA
Other
Enumeration date
10/24/2023
Last updated
09/19/2024
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