Provider Information for 1386089092
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TYLER G NEWMAN LICSW
Sex: Male
NPI: 1386089092
Last Updated: 2023-12-12
Certification Date: 2023-12-12
Certification Date: 2023-12-12
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1386089092 | ||||||||||||
| Enumeration Date | 2013-05-08 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1832 OAKMONT DR SE CULLMAN, AL 35055-5432 United States Phone: 256-339-8041 | Fax: | ||||||||||||
| Primary Practice Address | 1832 OAKMONT DR SE CULLMAN, AL 35055-5432 United States Phone: 256-339-8041 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 1909 COMMERCE AVE | ||||||||||||
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