Individual provider · Type 1 NPI
Tyler Young Quattlebaum, LPC
Mental Health Counselor · Fayetteville, AR
NPI number
1366930802
Active
Practice location
19 E Mountain St Ste 1
Fayetteville, AR 72701-6067
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | P2210005 (AR) |
Mental Health Counselor: Definition to come...
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About NPI 1366930802
Tyler Young Quattlebaum, LPC's National Provider Identifier is 1366930802, issued on Apr 30, 2018. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Fayetteville, AR. The record was last updated on Oct 10, 2022.