| Ty B. Aller, Lmft, Pllc | |
|
545 W 465 N Ste 130 Providence UT 84332-8005 | |
| (385) 200-3993 | |
| Not Available |
| Full Name | Ty B. Aller, Lmft, Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 545 W 465 N Ste 130, Providence, Utah |
| Authorized Official Name and Position | Ty Aller (PRESIDENT) |
| Authorized Official Contact | 3852003993 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ty B. Aller, Lmft, Pllc Po Box 583 Providence UT 84332-0583 Ph: (385) 200-3993 | Ty B. Aller, Lmft, Pllc 545 W 465 N Ste 130 Providence UT 84332-8005 Ph: (385) 200-3993 |
| NPI Number | 1164999835 |
|---|---|
| Provider Enumeration Date | 10/31/2018 |
| Last Update Date | 10/31/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164999835 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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