DERRELL R. TIDWELL

PORT TOWNSEND, WA
NPI1871661074
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker Clinical
(Licence: CA  9609)
Enumeration Date2006-12-04
Last Update Date2024-02-14
Business Address
MR. DERRELL R. TIDWELL LCSW
432 30TH STREET
PORT TOWNSEND, WA 98368
Phone number: 310-670-4295
Mailing Address
MR. DERRELL R. TIDWELL LCSW
432 30TH STREET
PORT TOWNSEND, WA 98368
Phone number: 310-871-2954