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General NPI Number Information
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NPI Number | 1740880061
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Entity Type | Organization
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Legal Business Name | PLEDGER BEHAVIOR CONSULTING, LLC
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Dates
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Enumeration Date | 10/27/2020
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Last Update Date | 10/27/2020
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Provider Practice Location Address
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Address Line | 7563 HIGHWAY 337
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City | SUMMERVILLE
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State | GA
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Zip | 30747-6101
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Country | US
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Telephone | 706-862-2310
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 66
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City | MENLO
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State | GA
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Zip | 30731-0066
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Country | US
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Telephone | 706-506-2113
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Fax |
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Authorized Official
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Title or Position | BOARD CERTIFIED BEHAVIOR ANALYST
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Name | MR. TYLER WAYNE PLEDGER
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Credential | MS, BCBA
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Telephone | 706-506-2113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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