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General NPI Number Information
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NPI Number | 1275517005
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Entity Type | Individual
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Provider Name | DEBORAH K. TYSON PHD
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Gender | Female
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Dates
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Enumeration Date | 12/05/2005
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Last Update Date | 07/01/2020
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Provider Practice Location Address
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Address Line | 7700 NORTH KENDALL DRIVE SUITE 413
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City | MIAMI
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State | FL
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Zip | 33156-7565
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Country | US
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Telephone | 305-595-8225
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Fax | 305-596-6947
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Provider Business Mailing Address
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Address Line | 9021 SW 94 STREET APT 208
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City | MIAMI
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State | FL
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Zip | 33176-2311
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Country | US
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Telephone | 305-595-8225
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY4181
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PY4181
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License Number State | FL
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