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1770825697
TERESA ELAINE TIDWELL
VANCOUVER, WA
NPI
1770825697
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date
2013-03-18
Last Update Date
2013-03-18
Business Address
MRS. TERESA ELAINE TIDWELL MA, CDPT
1601 E 4TH PLAIN BLVD BLDG 17 STE B222
VANCOUVER, WA 98661-3753
Phone number: 360-397-8484
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Mailing Address
MRS. TERESA ELAINE TIDWELL MA, CDPT
PO BOX 1845
VANCOUVER, WA 98668-1845
Phone number: 360-397-8484
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