Provider Demographics
NPI:1518724863
Name:TYLER, KIARA CHARDAE
Entity Type:Individual
Prefix:
First Name:KIARA
Middle Name:CHARDAE
Last Name:TYLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18472 SUNRISE OAKS CT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77316-4222
Mailing Address - Country:US
Mailing Address - Phone:936-777-3405
Mailing Address - Fax:
Practice Address - Street 1:32502 TAMINA RD
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-2260
Practice Address - Country:US
Practice Address - Phone:936-206-5158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician