MEDICARE: TYMES' THERAPEUTIC SOLUTION, LLC

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1548935398
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TYMES' THERAPEUTIC SOLUTION, LLC

Provider Business Mailing Address
First Line	:	5330 STADIUM TRACE PKWY STE 106
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-4526
Country	:	US
Telephone Number	:	334-221-2552
Fax Number	:

Provider Business Practice Location Address
First Line	:	5330 STADIUM TRACE PKWY STE 106
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-4526
Country	:	US
Telephone Number	:	334-221-2552
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	VERONICA TYMES
Credential	:
Telephone Number	:	334-221-2552

Provider Enumeration Date	:	08/13/2021
Last Update Date	:	08/13/2021

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