Dority, Tyler Maxwell
Dority, Tyler Maxwell is an sole proprietor health care provider with primary practice located at 12 Civic Center Plz Ste 1615 , Mankato MN 56001-7783. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Dority, Tyler Maxwell can be contacted via phone (507) 345-4679.Contact Information
Primary practice address
12 Civic Center Plz Ste 1615
Mankato MN 56001-7783
Phone: (507) 345-4679
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counseling | 103TC1900X | LP6328 | Minnesota |
| Behavioral Health & Social Service Providers / Forensic | 103TF0200X | LP6328 | Minnesota |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | LP6328 | Minnesota |
Profile Details
| NPI number | 1104394212 |
|---|---|
| LBN Legal business name | Dority, Tyler Maxwell |
| Credentials | PHD, LP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 6th, 2018 |
| Last updated | Aug 2nd, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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