Individual provider · Type 1 NPI

Tyler Broderick, MS, LPC

Professional Counselor · Buffalo, WY

NPI number 1396080917 Active

Practice location

521 W Lott St
Buffalo, WY 82834-1642

Call (307) 684-5531 Map

Fax (307) 684-2912

Mailing address

909 Long Dr Ste C
Sheridan, WY 82801-3282

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800XPPC721 (WY)
Professional Counselor Primary 101YP2500XLPC-1434 (WY)

Professional Counselor: Definition to come...

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About NPI 1396080917

Tyler Broderick, MS, LPC's National Provider Identifier is 1396080917, issued on Dec 7, 2012. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Buffalo, WY. The record was last updated on Jul 9, 2019.