Individual
MICHAEL TISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
2566 BAINBRIDGE AVE APT 4A, BRONX, NY 10458-4664
(646) 532-1332
Mailing address
2566 BAINBRIDGE AVE APT 4A, BRONX, NY 10458-4664
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001879
NY
Other
Enumeration date
04/03/2022
Last updated
04/03/2022
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