Individual
STEPHANIE TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
451 NEWPORT DR, NAPERVILLE, IL 60565-3104
(815) 531-9289
Mailing address
451 NEWPORT DR, NAPERVILLE, IL 60565-3104
(815) 531-9289
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/12/2023
Last updated
06/12/2023
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