Individual
MISS KAYLA D TYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3425 N FUTRALL DR, FAYETTEVILLE, AR 72703-4811
(479) 713-8350
(479) 713-8375
Mailing address
PO BOX 251420, LITTLE ROCK, AR 72225-1420
(501) 686-8000
(501) 526-5148
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7575-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189742721
—
AR
Enumeration date
01/04/2012
Last updated
10/03/2024
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