SHAWNTA' TYRRELL TISDALE

CONWAY, SC
NPI1235162553
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
Enumeration Date2006-07-09
Last Update Date2007-07-08
Business Address
-- SHAWNTA' TYRRELL TISDALE
164 WACCAMAW MEDICAL PARK DR
CONWAY, SC 29526-8903
Phone number: 843-347-5060
Mailing Address
-- SHAWNTA' TYRRELL TISDALE
1184 SUMTER HWY
KINGSTREE, SC 29556-4951
Phone number: 843-382-3867
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