Gorham, Tyler Grant

Gorham, Tyler Grant is an individual health care provider with primary practice located at 545 W 465 N Ste 100 , Providence UT 84332-8004. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavioral Analyst, Behavioral Health & Social Service Providers / Behavior Technician. Behavioral Health & Social Service Providers / Behavioral Analyst is his primary health care specialty. Gorham, Tyler Grant can be contacted via phone (801) 655-4950.

Contact Information

Primary practice address
545 W 465 N Ste 100 Providence UT 84332-8004
Phone: (801) 655-4950
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X Utah

Profile Details

NPI number 1114638558
LBN Legal business name Gorham, Tyler Grant
Credentials RBT
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2022
Last updated Sep 22nd, 2023 - 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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