Tysor-Tetley, Mary E
Tysor-Tetley, Mary E is an individual health care provider with primary practice located at 339 Cajon St Ste B, Redlands CA 92373-5901. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Tysor-Tetley, Mary E can be contacted via phone (909) 783-1078.Contact Information
Primary practice address
339 Cajon St Ste B
Redlands CA 92373-5901
Phone: (909) 783-1078
Fax: (909) 801-8070
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | T14553 | California |
Profile Details
| NPI number | 1477543643 |
|---|---|
| LBN Legal business name | Tysor-Tetley, Mary E |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 27th, 2005 |
| Last updated | Jul 8th, 2007 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477543643 | NPPES |
| Other | 11634766 | CAQH |
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