Individual
JACLYNN MARIE TYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
900 W 1ST ST STE 200, RENO, NV 89503-5587
(775) 322-8941
Mailing address
4500 MIRA LOMA DR APT 198, RENO, NV 89502-5440
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
01963-I
NV
Other
Enumeration date
03/09/2016
Last updated
03/09/2016
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