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1568810315
DELANE TIDZUMP
FORT WASHAKIE, WY
NPI
1568810315
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
175T00000X Peer Specialist
Enumeration Date
2016-06-01
Last Update Date
2016-06-01
Business Address
-- DELANE TIDZUMP
#7 SHIPTON LANE
FORT WASHAKIE, WY 82514-0538
Phone number: 307-335-1169
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Mailing Address
-- DELANE TIDZUMP
PO BOX 538
FORT WASHAKIE, WY 82514-0538
Phone number: 307-335-1169
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