Provider Demographics
NPI:1881416998
Name:CHRISTOPHER, TYLER DAVID (MS)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:DAVID
Last Name:CHRISTOPHER
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BUMPS POND ROAD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 207
Practice Address - Street 2:
Practice Address - City:SOUTH CARVER
Practice Address - State:MA
Practice Address - Zip Code:02366-0207
Practice Address - Country:US
Practice Address - Phone:508-291-2441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)