Individual
CAINNA TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
3004 W 34TH AVE, PINE BLUFF, AR 71603-5502
(870) 534-1880
Mailing address
2500 RIKE DR, PINE BLUFF, AR 71603-3937
(870) 534-1834
(870) 534-5798
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116378726
—
AR
Enumeration date
06/30/2017
Last updated
06/30/2017
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