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:
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Health care specialties

SpecialtyCodeLicense #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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