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1003250754
CAROL TIDWELL
EAGLE, ID
NPI
1003250754
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: ID LCPC-5223)
Enumeration Date
2013-04-24
Last Update Date
2023-06-05
Business Address
Ms. CAROL TIDWELL MS. LCPC
225 S LINDER RD APT A308
EAGLE, ID 83616-4421
Phone number: 208-546-1808
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Mailing Address
Ms. CAROL TIDWELL MS. LCPC
225 S LINDER RD APT A308
EAGLE, ID 83616-4421
Phone number: 208-794-9502
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