Provider Demographics
NPI:1134463854
Name:FLETCHER, TYLER JOSHUA (MA, CFY-SLP)
Entity Type:Individual
Prefix:MR
First Name:TYLER
Middle Name:JOSHUA
Last Name:FLETCHER
Suffix:
Gender:M
Credentials:MA, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 AMBERWOOD DRIVE
Mailing Address - Street 2:APARTMENT 10
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701
Mailing Address - Country:US
Mailing Address - Phone:402-340-6409
Mailing Address - Fax:
Practice Address - Street 1:1309 AMBERWOOD DR
Practice Address - Street 2:APARTMENT 10
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-1716
Practice Address - Country:US
Practice Address - Phone:402-340-6409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE350235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist