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NPI Profile for TRACI J TYLAR in PEORIA, IL.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X |
| NPI Number | 1053462952 |
|
| Status | Active | |
| Credentials | LPC (Licensed Professional Counselor) | |
| Entity | Individual | |
| Enumeration date | 01/16/2007 | |
| Last updated | 03/08/2012 - About 14 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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TRACI J TYLAR
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TRACI J TYLAR, LPC