Provider Demographics
NPI:1164982997
Name:TYLER, PATRICK CORRIGAN (BCBA)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:CORRIGAN
Last Name:TYLER
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5304 HARBINGER RD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-1956
Mailing Address - Country:US
Mailing Address - Phone:320-444-5635
Mailing Address - Fax:
Practice Address - Street 1:5304 HARBINGER RD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-1956
Practice Address - Country:US
Practice Address - Phone:320-444-5635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst