| NPI | 1750791885 |
|---|---|
| Former Name | FELICIA HOLLY TYSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C009740) |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2019-07-18 |