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1114551231
JANESSA LYNN TIDWELL
GOODYEAR, AZ
NPI
1114551231
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist
(Licence: MO TSLP12279)
Enumeration Date
2020-02-27
Last Update Date
2020-02-27
Business Address
JANESSA LYNN TIDWELL CF-SLP
13575 W MCDOWELL RD
GOODYEAR, AZ 85395-2604
Phone number: 623-536-9911
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Mailing Address
JANESSA LYNN TIDWELL CF-SLP
12376 W DEVONSHIRE AVE
AVONDALE, AZ 85392-4258
Phone number: 417-650-1146
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