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1770098543
COLBY MICHAEL TYSON
RIO RANCHO, NM
NPI
1770098543
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
Additional Taxonomies
373H00000X Day Training/Habilitation Specialist
Enumeration Date
2017-12-02
Last Update Date
2024-01-23
Business Address
COLBY MICHAEL TYSON
1207 GOLF COURSE RD SE
RIO RANCHO, NM 87124-1999
Phone number: 505-994-4100
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Mailing Address
COLBY MICHAEL TYSON
6001 MOON ST NE APT 2126
ALBUQUERQUE, NM 87111-1456
Phone number: 505-918-2901
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