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General NPI Number Information
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NPI Number | 1376787853
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Entity Type | Individual
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Provider Name | MARY FRANCES TYSON-MARCHINO MFT, CSAC, RPT
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Gender | Female
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Dates
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Enumeration Date | 04/28/2009
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Last Update Date | 06/14/2016
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Provider Practice Location Address
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Address Line | 3417 POIPU RD #104
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City | KOLOA
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State | HI
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Zip | 96756-8546
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Country | US
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Telephone | 808-652-2862
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Fax | 808-320-3933
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Provider Business Mailing Address
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Address Line | PO BOX 339
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City | KALAHEO
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State | HI
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Zip | 96741-0339
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Country | US
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Telephone | 808-652-2862
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Fax | 808-320-3933
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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