Individual
TYLER HART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1905 S TOPAZ WAY STE 100, MERIDIAN, ID 83642-4477
(208) 518-0870
Mailing address
1410 48TH ST, MARION, IA 52302-9478
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/31/2023
Last updated
03/31/2023
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