| Emily C Tyson, | |
|
90 S Park St Ste 2, Willimantic, CT 06226-3336 | |
| (860) 207-0499 | |
| Not Available |
| Full Name | Emily C Tyson |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 90 S Park St Ste 2, Willimantic, Connecticut |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487212734 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 003673 (Connecticut) | Primary |
| Entity Name | Grow Healthcare Group Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220512000081 |
| Mailing Address | Practice Location Address |
|---|---|
| Emily C Tyson, 90 S Park St Ste 2, Willimantic, CT 06226-3336 Ph: (860) 207-0499 | Emily C Tyson, 90 S Park St Ste 2, Willimantic, CT 06226-3336 Ph: (860) 207-0499 |
William Bergmann, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1491 Main St, Willimantic, CT 06226 Phone: 860-456-3215 | |
Elicia L Jones, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1310 Main St, Willimantic, CT 06226 Phone: 860-731-5522 Fax: 890-731-5536 | |
Ms. Jessica M Diaz, MASTER OF ARTS Counselor Medicare: Not Enrolled in Medicare Practice Location: 132 Mansfield Ave, Willimantic, CT 06226 Phone: 860-456-2261 | |
Ning Cruzado, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1310 Main St, Willimantic, CT 06226 Phone: 860-731-5522 Fax: 860-731-5536 | |
Amanda Church, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1310 Main St, Willimantic, CT 06226 Phone: 860-731-5522 Fax: 860-731-5536 | |
Kelly M Shepard, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1310 Main St, Willimantic, CT 06226 Phone: 860-731-5522 Fax: 890-731-5536 | |
Felicia Ca Martin, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1310 Main St, Willimantic, CT 06226 Phone: 860-731-5522 Fax: 890-731-5536 |