| NPI | 1508326844 |
|---|---|
| Former Name | SHELBY L. TISDALE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 9392) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2024-06-28 |