Individual
DONALD TYLER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSAA
Contact information
Practice address
1712 GOLF COURSE RD SE, RIO RANCHO, NM 87124-1763
(505) 850-7103
Mailing address
1712 GOLF COURSE RD SE, RIO RANCHO, NM 87124-1763
(505) 850-7103
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2024-0663
NM
Other
Enumeration date
04/14/2025
Last updated
04/14/2025
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