Provider Demographics
NPI:1558182907
Name:RHOADES, TYLER RAY (MFT INTERN)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:RAY
Last Name:RHOADES
Suffix:
Gender:M
Credentials:MFT INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 NEW WAY
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-9382
Mailing Address - Country:US
Mailing Address - Phone:541-884-1841
Mailing Address - Fax:541-851-3988
Practice Address - Street 1:6000 NEW WAY
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-9382
Practice Address - Country:US
Practice Address - Phone:541-884-1841
Practice Address - Fax:541-851-3988
Is Sole Proprietor?:No
Enumeration Date:2024-10-18
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist