Individual
COLBY MICHAEL TYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5201 VENICE AVE NE STE A, ALBUQUERQUE, NM 87113-2337
(505) 796-6367
Mailing address
6416 TAUTON RD NW, ALBUQUERQUE, NM 87120-2040
(505) 918-2901
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CTB2024668
NM
Other
Enumeration date
12/02/2017
Last updated
01/06/2025
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