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NPI Code Detail

MEDICARE: TYLER STRADFORD

MEDICARE: TYLER STRADFORD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1578003869
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYLER STRADFORD
Provider Business Mailing Address
First Line : 3221 BEHRMAN PLACE SUITE 201
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70114
Country : US
Telephone Number : 504-263-2800
Fax Number :
Provider Business Practice Location Address
First Line : 3221 BEHRMAN PL STE 201
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70114-8204
Country : US
Telephone Number : 504-263-2800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2017
Last Update Date : 03/06/2017

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Directions to “ TYLER STRADFORD ” Practice Location

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