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Individual
BENJAMIN TYLER FOWLER
Active
Individual
BENJAMIN TYLER FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-26-90082
GA
106S00000X
Behavior Technician
Primary
RBT-22-202611
VA
Other
Enumeration date
05/24/2022
Last updated
05/22/2026
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