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NPI Code Detail

MEDICARE: CRYSTAL TYLER

MEDICARE: CRYSTAL TYLER
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 : 1609727247
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL TYLER
Provider Business Mailing Address
First Line : 3993 MEMORIAL BLVD
Second Line :
City : SPRINGFIELD
State : TN
Zip : 37172-4200
Country : US
Telephone Number : 615-203-0900
Fax Number : 615-203-0900
Provider Business Practice Location Address
First Line : 3993 MEMORIAL BLVD
Second Line :
City : SPRINGFIELD
State : TN
Zip : 37172-4200
Country : US
Telephone Number : 615-203-0900
Fax Number : 615-203-0900
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2026
Last Update Date : 02/09/2026

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Directions to “ CRYSTAL TYLER ” Practice Location

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