Individual
STEPHANIE TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2240 E WINROW AVE, USA MEDDAC MISC, FORT HUACHUCA, AZ 85613-7079
(520) 533-9951
Mailing address
159B GRIERSON AVE, FORT HUACHUCA, AZ 85613-1330
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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