Provider Demographics
NPI:1124871579
Name:TUELLER, CADE RECTOR
Entity type:Individual
Prefix:
First Name:CADE
Middle Name:RECTOR
Last Name:TUELLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3686 N 820 E
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-4771
Mailing Address - Country:US
Mailing Address - Phone:801-362-1643
Mailing Address - Fax:
Practice Address - Street 1:3686 N 820 E
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-4771
Practice Address - Country:US
Practice Address - Phone:801-362-1643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty