Search › Wyoming › 101YP2500X
Tyler Broderick, MS, LPC
NPI 1396080917 · on the registry since 2012
Practice
- Address
- 521 W Lott St
Buffalo, WY 82834 - Phone
- (307) 684-5531
- Fax
- (307) 684-2912
- Organisation at this address
- Volunteers Of America Northern Rockies
Volunteers Of America Northern RockiesInferred from a shared address, not stated in the registry. - Clinicians at this address
- 16
Registry record
- Primary taxonomy
- 101YP2500X
101YP2500X
- Also registered as
- 101YM0800X
- Licence states on file
- WY
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2019-07-09
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wyoming