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NPI Code Detail

MEDICARE: ADDIE TYSON

MEDICARE:   ADDIE  TYSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior AnalystBH005847PA
2106S00000XBehavior TechnicianRBT-20-125942PA

General Provider Information

NPI Number : 1144827643
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADDIE TYSON
Provider Business Mailing Address
First Line : 8650 BABCOCK BLVD
Second Line :
City : PITTSBURGH
State : PA
Zip : 15237-5009
Country : US
Telephone Number : 412-283-6107
Fax Number :
Provider Business Practice Location Address
First Line : 3000 MCKNIGHT EAST DR STE 102
Second Line :
City : PITTSBURGH
State : PA
Zip : 15237-6422
Country : US
Telephone Number : 412-295-6734
Fax Number : 412-837-1290
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2020
Last Update Date : 05/26/2026

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Directions to “ ADDIE TYSON ” Practice Location

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