Individual provider · Type 1 NPI
Kelly Segraves Tyson, M.S.
Mental Health Counselor · Grovetown, GA
NPI number
1164769261
Active
Practice location
3913 Griese Ln
Grovetown, GA 30813-8301
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | APC003687 (GA) |
Mental Health Counselor: Definition to come...
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About NPI 1164769261
Kelly Segraves Tyson, M.S.'s National Provider Identifier is 1164769261, issued on Jan 9, 2013. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Grovetown, GA. The record was last updated on Apr 30, 2015.