Provider Demographics
NPI:1235429754
Name:TYLER, MELINDA MARY (MA, MFT)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:MARY
Last Name:TYLER
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:PRESTON
Mailing Address - State:CT
Mailing Address - Zip Code:06365-8023
Mailing Address - Country:US
Mailing Address - Phone:860-639-4953
Mailing Address - Fax:888-509-7271
Practice Address - Street 1:84 RIVER RD
Practice Address - Street 2:
Practice Address - City:PRESTON
Practice Address - State:CT
Practice Address - Zip Code:06365-8023
Practice Address - Country:US
Practice Address - Phone:860-639-4953
Practice Address - Fax:888-509-7271
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-18
Last Update Date:2015-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist