Provider Demographics
NPI:1639724602
Name:WILLIAMS, TYLER BENNETT (MS, BCBA)
Entity Type:Individual
Prefix:MR
First Name:TYLER
Middle Name:BENNETT
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 RATHTON RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3717
Mailing Address - Country:US
Mailing Address - Phone:717-885-5906
Mailing Address - Fax:717-600-8179
Practice Address - Street 1:1 RATHTON RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3717
Practice Address - Country:US
Practice Address - Phone:717-885-5906
Practice Address - Fax:717-600-8179
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH004428103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst