DIANA TIDWELL

GALT, CA
NPI1750746335
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2015-12-23
Last Update Date2015-12-23
Business Address
-- DIANA TIDWELL
931 RANCH RD
GALT, CA 95632-8341
Phone number: 209-271-3968
Mailing Address
-- DIANA TIDWELL
931 RANCH RD
GALT, CA 95632-8341
Phone number: 209-271-3968
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