Individual provider · Type 1 NPI

Tyler Stark, LCMHC

Professional Counselor · Sandy, UT

NPI number 1598115669 Active

Practice location

11075 S State St Ste 16
Sandy, UT 84070-5196

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X8598755-6004 (UT)

Professional Counselor: Definition to come...

11 other providers at this address

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About NPI 1598115669

Tyler Stark, LCMHC's National Provider Identifier is 1598115669, issued on Jun 20, 2016. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Sandy, UT. The record was last updated on Jun 20, 2016.