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1942519616
GWEN DALE TYSON
STARKVILLE, MS
NPI
1942519616
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
(Licence: NC 7368)
Enumeration Date
2010-09-29
Last Update Date
2010-09-29
Business Address
GWEN DALE TYSON MS, LPC, NCC
57 TREVINO LN APT 11
STARKVILLE, MS 39759-4443
Phone number: 252-327-0407
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Mailing Address
GWEN DALE TYSON MS, LPC, NCC
2416 CHIPPENHAM CT
WINTERVILLE, NC 28590-9773
Phone number: 252-327-0407
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