Most Relevant Information
Provider Data
| NPI Number: | 1003582990 |
| Provider Name: | TYLER JULES KENNEDY MA, LAC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/19/2021 |
| Last Updated: | 08/19/2021 |
Provider Practice Location
32 MIDWOOD DR
FLORHAM PARK
NJ
079321811
Practice Location Phone/Fax
| Phone: | 9738655468 |
| Fax: |
Provider Mailing Location
114 PLOCH RD
CLIFTON
NJ
070131471
Provider Mailing Phone/Fax
| Phone: | 9738655468 |
| Fax: |