Provider Demographics
NPI:1851121206
Name:TYLER, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:TYLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6913 SW CHEROKEE AVE
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-6625
Mailing Address - Country:US
Mailing Address - Phone:940-432-2363
Mailing Address - Fax:
Practice Address - Street 1:701 SW F AVE
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73501-4542
Practice Address - Country:US
Practice Address - Phone:580-699-2700
Practice Address - Fax:817-382-2934
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-01
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician