Individual
TYLER MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTRL
Contact information
Practice address
9530 E TRILLIUM AVE, MESA, AZ 85212-9109
(616) 780-0534
Mailing address
9530 E TRILLIUM AVE, MESA, AZ 85212-9109
(616) 780-0534
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
5201008350
MI
225X00000X
Occupational Therapist
7132
AZ
225XP0200X
Pediatric Occupational Therapist
5201008350
MI
225XP0200X
Pediatric Occupational Therapist
Primary
7132
AZ
Other
Enumeration date
08/05/2014
Last updated
06/24/2019
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