Individual
DORNEISIA TYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
320 E WINTERGREEN RD APT 20H, DESOTO, TX 75115-2473
(469) 285-3755
Mailing address
320 E WINTERGREEN RD APT 20H, DESOTO, TX 75115-2473
(469) 285-3755
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/11/2020
Last updated
09/11/2020
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