Individual
TYSHAUN BLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S; M.A
Contact information
Practice address
19927 COUNTRY CLUB, HARPER WOODS, MI 48225-1154
(313) 627-8719
(313) 216-1776
Mailing address
19927 COUNTRY CLUB DR, HARPER WOODS, MI 48225-1621
(313) 627-8719
(313) 216-1776
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2-01445
MI
103K00000X
Behavior Analyst
—
—
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
09/12/2014
Last updated
11/18/2016
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