Individual
MR. TYSON BLAKE PROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., T-LMLP
Contact information
Practice address
120 S GORDY ST STE 3, EL DORADO, KS 67042-2900
(316) 321-6088
(316) 321-3957
Mailing address
120 S GORDY ST STE 3, EL DORADO, KS 67042-2900
(316) 321-6088
(316) 321-3957
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
T-LMLP 1146
KS
Other
Enumeration date
01/10/2008
Last updated
01/10/2008
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