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1063117976
KEVIN TISDALE
WASHINGTON, DC
NPI
1063117976
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101Y00000X Counselor
Enumeration Date
2023-03-31
Last Update Date
2023-06-14
Business Address
KEVIN TISDALE
4660 MARTIN LUTHER KING JR AVE SW
WASHINGTON, DC 20032-4933
Phone number: 202-318-0179
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Mailing Address
KEVIN TISDALE
1310 GALLATIN ST NW
WASHINGTON, DC 20011-6918
Phone number: 202-621-4239
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