Prouse, Tyson Blake
Prouse, Tyson Blake is an individual health care provider with primary practice located at 120 S Gordy St Ste 3 , El Dorado KS 67042-2900. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Prouse, Tyson Blake can be contacted via phone (316) 321-6088.Contact Information
Primary practice address
120 S Gordy St Ste 3
El Dorado KS 67042-2900
Phone: (316) 321-6088
Fax: (316) 321-3957
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | T-LMLP 1146 | Kansas |
Profile Details
| NPI number | 1952587792 |
|---|---|
| LBN Legal business name | Prouse, Tyson Blake |
| Credentials | M.S., T-LMLP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 10th, 2008 |
| Last updated | Jan 10th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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