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1174973614
SHALANTE A TYSON
MAITLAND, FL
NPI
1174973614
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: FL IMH15819)
Enumeration Date
2016-06-15
Last Update Date
2018-03-17
Business Address
SHALANTE A TYSON Ed.S.
1009 MAITLAND CENTER COMMONS BLVD STE 2212
MAITLAND, FL 32751-7270
Phone number: 352-213-9613
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Mailing Address
SHALANTE A TYSON Ed.S.
9645 BAYMEADOWS RD APT 637
JACKSONVILLE, FL 32256-7866
Phone number: 352-213-9613
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