Provider Demographics
NPI:1811501802
Name:TYLER MAJKA, ELIZABETH GABRIEL
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:GABRIEL
Last Name:TYLER MAJKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:GABRIEL
Other - Last Name:TYLER MAJKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:82 N FARMS RD
Mailing Address - Street 2:
Mailing Address - City:HAYDENVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01039-9712
Mailing Address - Country:US
Mailing Address - Phone:413-695-0653
Mailing Address - Fax:
Practice Address - Street 1:82 N FARMS RD
Practice Address - Street 2:
Practice Address - City:HAYDENVILLE
Practice Address - State:MA
Practice Address - Zip Code:01039-9712
Practice Address - Country:US
Practice Address - Phone:413-695-0653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-07
Last Update Date:2020-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist