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1588146062
KAREN MICHELLE TYSON
NEW HAVEN, CT
NPI
1588146062
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CT 1305)
Enumeration Date
2018-08-31
Last Update Date
2018-08-31
Business Address
KAREN MICHELLE TYSON LADC
62 GRANT STREET GRANT STREET PARTNERSHIP
NEW HAVEN, CT 06519-3456
Phone number: 203-503-3350
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Mailing Address
KAREN MICHELLE TYSON LADC
PO BOX 7720 CREDENTIALING SPECIALIST
NEW HAVEN, CT 06519-0720
Phone number: 203-503-3174
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