Provider Demographics
NPI:1760077952
Name:MORRILL, TYLER CRAIG
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:CRAIG
Last Name:MORRILL
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 1:11 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PLAISTOW
Mailing Address - State:NH
Mailing Address - Zip Code:03865-2618
Mailing Address - Country:US
Mailing Address - Phone:508-314-4770
Mailing Address - Fax:
Practice Address - Street 1:11 NORTH AVE
Practice Address - Street 2:
Practice Address - City:PLAISTOW
Practice Address - State:NH
Practice Address - Zip Code:03865-2618
Practice Address - Country:US
Practice Address - Phone:508-314-4770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician