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
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