Individual
MR. TYLER RYAN RETZLOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT, QASP-S
Contact information
Practice address
7552 NAVARRE PKWY UNIT 62, NAVARRE, FL 32566-7305
(850) 607-6910
(850) 607-6932
Mailing address
110 HUMMINGBIRD AVE NW, FORT WALTON BEACH, FL 32548-4345
(850) 586-3182
(850) 607-6932
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
QASP-S-11446
FL
106S00000X
Behavior Technician
RBT-19-98977
FL
Other
Enumeration date
09/13/2019
Last updated
08/02/2021
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