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Individual

WILLIE TYLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5555 ROSWELL RD # APTW12, ATLANTA, GA 30342-5814
(470) 602-1966
Mailing address
5555 ROSWELL RD # APTW12, ATLANTA, GA 30342-5814
(470) 602-1966

Taxonomy

Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
172A00000X
Driver
Primary
GA
175T00000X
Peer Specialist
GA
225800000X
Recreation Therapist
GA
253Z00000X
In Home Supportive Care Agency
GA
311ZA0620X
Adult Care Home Facility
347C00000X
Private Vehicle
GA
347E00000X
Transportation Broker
GA
372600000X
Adult Companion
GA

Other

Enumeration date
07/08/2025
Last updated
07/08/2025
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