Provider Demographics
NPI:1588477012
Name:MAY, TYLER (BA)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:MAY
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 HUDGINS ST
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:WV
Mailing Address - Zip Code:25601-3535
Mailing Address - Country:US
Mailing Address - Phone:606-625-5896
Mailing Address - Fax:
Practice Address - Street 1:313 HUDGINS ST
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:WV
Practice Address - Zip Code:25601-3535
Practice Address - Country:US
Practice Address - Phone:606-625-5896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker