NPI 1083162226

Tyler M. Stark, Lcmhc, Corp.

Organisation Community/Behavioral Health Agency Sandy, UT

Practice location

Address: 11075 S State St STE 16, Sandy, UT 84070-5196
Phone: (801) 948-0939

Authorised official

Name: Tyler M Stark
Title: Owner
Phone: (801) 948-0939

Registered specialties

Community/Behavioral Health Agency Primary

Agencies Taxonomy 251S00000X Licence 8598755-6004 (UT)

Other Community/Behavioral Health providers in Utah →

Registry record

NPI: 1083162226
Entity type: Organization
NPI issued: 16 Sep 2016
Record last updated: 16 Sep 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.