Individual
LISA TYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1649 61ST ST FL 3013, BROOKLYN, NY 11204-2110
(785) 229-6845
Mailing address
706 SCHOFIELD ST, WAVERLY, KS 66871-9723
(785) 229-6845
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
KS
Other
Enumeration date
06/06/2025
Last updated
06/13/2025
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