Dr. William Michael Tyson, PhD
Psychologist in Charlotte, NC. Individual provider (NPI-1).
NPI number1790763308
StatusActive
Last updated in NPPESJul 28, 2020
Details
- NPI
- 1790763308
- Entity type
- Individual (NPI-1)
- Name
- Dr. William Michael Tyson
- Credential
- PhD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 4, 2006
- Certification date
- Jul 28, 2020
- Last updated
- Jul 28, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | 1169 | NC | Yes |
| 103TC0700X | Psychologist, Clinical | 1169 | NC | |
| 103TF0200X | Psychologist, Forensic | 1169 | NC | |
| 103TP2701X | Psychologist, Group Psychotherapy | 1169 | NC |
Practice location
16426 Hawfield Woods LnCharlotte, NC 28277-6108
Phone 704-540-4291 · Fax 704-541-0319
Mailing address
16147 Lancaster Hwy Ste 110Charlotte, NC 28277-4196
Phone 704-540-4291 · Fax 704-541-0319
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