Provider Demographics
NPI:1871920710
Name:PLEDGER, TYLER WAYNE (MS, BCBA)
Entity type:Individual
Prefix:MR
First Name:TYLER
Middle Name:WAYNE
Last Name:PLEDGER
Suffix:
Gender:M
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:MENLO
Mailing Address - State:GA
Mailing Address - Zip Code:30731-0066
Mailing Address - Country:US
Mailing Address - Phone:706-506-2113
Mailing Address - Fax:
Practice Address - Street 1:7563 HWY. 337
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:GA
Practice Address - Zip Code:30747
Practice Address - Country:US
Practice Address - Phone:706-506-2113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-10
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst