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Individual

MR. TYLER LENNON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CADC, B.S.

Contact information

Practice address
726 S 17TH ST, FORT DODGE, IA 50501-5344
(515) 576-7261
(515) 955-7628
Mailing address
1630 11TH ST, MANSON, IA 50563-5026
(515) 571-8522

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15084
IA

Other

Enumeration date
10/20/2015
Last updated
10/20/2015
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