Provider Demographics
NPI:1942808498
Name:TYLER, BRANDI LEE (LPC)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:LEE
Last Name:TYLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:LEE
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:106 AUSTIN AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-3381
Mailing Address - Country:US
Mailing Address - Phone:817-597-8114
Mailing Address - Fax:
Practice Address - Street 1:106 AUSTIN AVE STE 207
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-3381
Practice Address - Country:US
Practice Address - Phone:817-597-8114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79536101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional