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1023752870
LAVELLE TYSON
GARDENDALE, AL
NPI
1023752870
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: AL LPC05027)
Enumeration Date
2022-04-26
Last Update Date
2023-10-19
Business Address
LAVELLE TYSON MAMFT, Ed.S., LPC
2603 DECATUR HWY STE 201
GARDENDALE, AL 35071-2187
Phone number: 205-374-8904
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Mailing Address
LAVELLE TYSON MAMFT, Ed.S., LPC
117 PLAZA CIR
ALABASTER, AL 35007-7018
Phone number: 205-624-2633
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