Individual
KRISTIE M TYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
11373 AMBOY LN, SAINT LOUIS, MO 63136-6102
(314) 355-6937
Mailing address
11373 AMBOY LN, SAINT LOUIS, MO 63136-6102
(314) 355-6937
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2007034772
MO
Other
Enumeration date
02/05/2008
Last updated
02/05/2008
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