Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Benjamin Tyler Bullard

Individual provider Behavior Technician · NPI 1538785977

Benjamin Tyler Bullard is a Behavior Technician in Fayetteville, Georgia. Licensed in Georgia. Registered with an NPI since 2020.

Licensed in
GA
In the registry since
2020

Practice location Address checks out

126 Pavilion Pkwy
Fayetteville, GA 30214-4056
Phone: (770) 954-8988
Fax: (317) 520-8200
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X · Licence RBT-19-90487 (GA)

Record details

NPI number1538785977
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 22, 2020
Last updated in NPPESJune 22, 2020
Certification dateJune 22, 2020

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