Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | UT | |
N | 103T00000X | Psychologist | UT | |
Y | 102L00000X | Psychologist | UT | |
Y | 103T00000X | Psychologist | UT |
NPI | 1013928415 |
---|---|
Provider Name | Dr. Ann H Tyler |
First Address | Salt Lake City, UT 84124 |
Second Address | Salt Lake City, UT 84124 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 08/07/2007 |