TYSON FABYANSKE

NEW BRIGHTON, MN
NPI1194171736
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN  303921)
Enumeration Date2016-05-12
Last Update Date2016-05-12
Business Address
-- TYSON FABYANSKE MA, LADC
1900 SILVER LAKE RD NW STE 110
NEW BRIGHTON, MN 55112-1789
Phone number: 651-628-9566
Mailing Address
-- TYSON FABYANSKE MA, LADC
1900 SILVER LAKE RD NW STE 110
NEW BRIGHTON, MN 55112-1789
Phone number: