Individual
DR. CARMEN MARIE TYLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1900 E MAIN ST, DANVILLE, IL 61832-5100
(217) 554-5199
Mailing address
3209 E MAIN ST, DANVILLE, IL 61834-9382
(904) 263-8945
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20043884A
IN
103TA0700X
Adult Development & Aging Psychologist
20043884A
IN
103TC0700X
Clinical Psychologist
20043884A
IN
103TC1900X
Counseling Psychologist
20043884A
IN
103TP2701X
Group Psychotherapy Psychologist
20043884A
IN
Other
Enumeration date
11/26/2024
Last updated
11/26/2024
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