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1770729998
ANGELA KIM TIDWELL
JACKSON, MS
NPI
1770729998
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Other Name
KIM HESTLE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: MS S2357)
Enumeration Date
2008-12-17
Last Update Date
2023-02-22
Business Address
ANGELA KIM TIDWELL SLP
733 N. FLAG CHAPEL ROAD
JACKSON, MS 39209
Phone number: 601-922-5530
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Mailing Address
ANGELA KIM TIDWELL SLP
147 PECAN HILL DR
CLINTON, MS 39056-5233
Phone number: 601-862-9265
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