Individual
TYLER WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1432 W FOREST HOME AVE STE 400, MILWAUKEE, WI 53204-3228
(414) 567-5400
(414) 567-5359
Mailing address
10431 W FAIRLANE AVE, MILWAUKEE, WI 53224-2650
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11116-125
WI
Other
Enumeration date
06/18/2024
Last updated
06/27/2024
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