Organization
TYNES AND ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHERINE M TYNES LCSW (OWNER)
(417) 883-2725
Entity
Organization
Contact information
Practice address
2021 S WAVERLY AVE STE 700, SPRINGFIELD, MO 65804-2400
(417) 883-2725
(417) 883-5653
Mailing address
2021 S WAVERLY AVE STE 700, SPRINGFIELD, MO 65804-2400
(417) 883-2725
(417) 883-5653
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
000420
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA3382
MEDICARE PTAN
MO
Enumeration date
05/22/2012
Last updated
06/21/2012
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