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:
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Health care specialties

SpecialtyCodeLicense #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 19 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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Identifiers

StateTypeNumberIssuer
All States NPI 1477543643 NPPES
Other 11634766 CAQH

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