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1790189413
STACEY TIDWELL
STOCKTON, CA
NPI
1790189413
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041S0200X Social Worker, School
Enumeration Date
2014-10-09
Last Update Date
2021-12-30
Business Address
STACEY TIDWELL LCSW
3311 MORADA LN
STOCKTON, CA 95212-3148
Phone number: 209-647-3047
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Mailing Address
STACEY TIDWELL LCSW
3311 MORADA LN
STOCKTON, CA 95212-3148
Phone number: 209-647-3047
Copy
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