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1194171736
TYSON FABYANSKE
NEW BRIGHTON, MN
NPI
1194171736
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN 303921)
Enumeration Date
2016-05-12
Last Update Date
2016-05-12
Business Address
-- TYSON FABYANSKE MA, LADC
1900 SILVER LAKE RD NW STE 110
NEW BRIGHTON, MN 55112-1789
Phone number: 651-628-9566
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Mailing Address
-- TYSON FABYANSKE MA, LADC
1900 SILVER LAKE RD NW STE 110
NEW BRIGHTON, MN 55112-1789
Phone number:
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