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1609213446
LORISA DAWN TIDWELL
OKLAHOMA CITY, OK
NPI
1609213446
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: OK 4407)
Enumeration Date
2013-06-03
Last Update Date
2015-04-09
Business Address
-- LORISA DAWN TIDWELL LCSW
2632 LYNN LN
OKLAHOMA CITY, OK 73120-1702
Phone number: 402-366-8796
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Mailing Address
-- LORISA DAWN TIDWELL LCSW
247 CUMBERLAND LN
ARDMORE, OK 73401-7568
Phone number: 405-693-6061
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