Individual
ALYCIA TYLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9424 256TH ST N, PORT BYRON, IL 61275-9727
(309) 523-3186
Mailing address
4217 53RD AVE, BETTENDORF, IA 52722-1225
(630) 402-7099
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242.004812
IL
Other
Enumeration date
08/23/2018
Last updated
08/23/2018
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