Provider Demographics
NPI:1326939174
Name:MOORE, TYLER FOREST (MS)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:FOREST
Last Name:MOORE
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:378 N WYANDOTTE ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:AR
Mailing Address - Zip Code:72730-6012
Mailing Address - Country:US
Mailing Address - Phone:281-217-8631
Mailing Address - Fax:281-217-8631
Practice Address - Street 1:480 N CAMPUS WALK
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-4006
Practice Address - Country:US
Practice Address - Phone:479-575-4258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health