Individual
TYSON FABYANSKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LADC
Contact information
Practice address
1900 SILVER LAKE RD NW STE 110, NEW BRIGHTON, MN 55112-1789
(651) 628-9566
Mailing address
1900 SILVER LAKE RD NW STE 110, NEW BRIGHTON, MN 55112-1789
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
303921
MN
Other
Enumeration date
05/12/2016
Last updated
05/12/2016
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