Organization
BRAVE COUNSELING AND CONSULTATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYSON PROUSE (OWNER)
(620) 794-6635
Entity
Organization
Contact information
Practice address
1512 W 6TH AVE STE B, EMPORIA, KS 66801-2400
(620) 208-6577
(620) 412-8954
Mailing address
982 ROAD 220, EMPORIA, KS 66801-7930
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
09/16/2022
Last updated
09/16/2022
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