person
Tyler Broderick, MS,LPC
Professional Counselor in Buffalo, Wyoming
NPI 1396080917

Tyler Broderick is a Professional Counselor based in Sheridan, WY and is specialized in Professional. Tyler Broderick practices in Buffalo, WY and has the professional credentials of MS,LPC. The NPI Number for Tyler Broderick is 1396080917 and holds a License No. PPC721 (Wyoming).

The current practice location address for Tyler Broderick is 521 W Lott St, Buffalo, WY and can be reached out via phone at 307-684-5531 and via fax at 307-684-2912. You can also correspond with Tyler Broderick through the mailing address at 909 LONG DR STE C, SHERIDAN, WY - 82801-3282 (mailing address contact number: 307-672-8958).

Location: 521 W Lott St, Buffalo, WY, 82801-3282
person
Provider Profile Details
NPI Number
1396080917
Provider Name
Tyler Broderick
Credential
MS,LPC
Provider Entity Type
Individual
Gender
Male
Address
521 W Lott St, Buffalo, WY, 82801-3282
Phone Number
307-684-5531
Fax Number
307-684-2912
Provider Enumeration Date
12/07/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
521 W Lott St
City
State
Zip
82834-1642
Phone Number
307-684-5531
Fax Number
307-684-2912
person
Provider Business Mailing Address Details
Address
909 Long Dr Ste C
City
State
Zip
82801-3282
Phone Number
307-672-8958
Fax Number
307-672-8950
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
LPC-1434 (Wyoming)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
PPC721 (Wyoming)
Definition
Definition to come...
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