Individual
DR. WILLIAM MICHAEL TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
16426 HAWFIELD WOODS LN, CHARLOTTE, NC 28277-6108
(704) 540-4291
(704) 541-0319
Mailing address
16147 LANCASTER HWY STE 110, CHARLOTTE, NC 28277-4196
(704) 540-4291
(704) 541-0319
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1169
NC
103TC0700X
Clinical Psychologist
1169
NC
103TF0200X
Forensic Psychologist
1169
NC
103TP2701X
Group Psychotherapy Psychologist
1169
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
461457000
MAGELLAN
NC
Enumeration date
01/04/2006
Last updated
07/28/2020
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