Individual
JONATHAN GREGORY TYLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
420 28TH AVE, TUSCALOOSA, AL 35401-1088
(205) 737-3720
Mailing address
4909 MADISON CIR, NORTHPORT, AL 35475-4468
(205) 454-4479
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3578G
AL
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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