Organization
TYLER T WHITNEY PSYD PC
Active
Other names
Intermountain Center for Autism & Child Development
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER T WHITNEY PSYD (PRESIDENT)
(208) 888-7104
Entity
Organization
Contact information
Practice address
2273 E GALA ST, SUITE 120, MERIDIAN, ID 83642-7289
(208) 888-7104
(208) 321-4789
Mailing address
2273 E GALA ST, SUITE 120, MERIDIAN, ID 83642-7289
(208) 888-7104
(208) 321-4789
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
SE-202327
ID
101YM0800X
Mental Health Counselor
Primary
SE202-374
ID
103T00000X
Psychologist
PSY202-131
ID
Other
Enumeration date
04/23/2007
Last updated
09/11/2025
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