Healthcare Provider Details

I. General information

NPI: 1245750835
Provider Name (Legal Business Name): LORI LYNN TYLER BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2017
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 MONROVIA ST STE 310
LENEXA KS
66215-3500
US

IV. Provider business mailing address

8700 MONROVIA ST STE 310
LENEXA KS
66215-3500
US

V. Phone/Fax

Practice location:
  • Phone: 317-563-0845
  • Fax: 317-936-1241
Mailing address:
  • Phone: 317-563-0845
  • Fax: 317-936-1241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-17-28971
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: