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1457605479
SUSIE TIDWELL
ARDMORE, OK
NPI
1457605479
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2012-10-29
Last Update Date
2012-10-29
Business Address
-- SUSIE TIDWELL
32 N WASHINGTON ST
ARDMORE, OK 73401-7013
Phone number: 580-226-5209
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Mailing Address
-- SUSIE TIDWELL
PO BOX 48
MEAD, OK 73449-0048
Phone number: 580-745-9610
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