Provider Demographics
NPI:1982838611
Name:CARLYON, WILLIAM DAVID (PHD, BCABA)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DAVID
Last Name:CARLYON
Suffix:
Gender:M
Credentials:PHD, BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6004 W KNOX ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-4444
Mailing Address - Country:US
Mailing Address - Phone:813-889-7378
Mailing Address - Fax:
Practice Address - Street 1:6004 W KNOX ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-4444
Practice Address - Country:US
Practice Address - Phone:813-889-7378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-09
Last Update Date:2009-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst