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Individual
MARY M TIDYMAN
Active
Individual
MARY M TIDYMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LIMHP, LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1280
NE
101YM0800X
Mental Health Counselor
Primary
14180
NE
101YM0800X
Mental Health Counselor
Primary
4624
NE
Other
Enumeration date
11/04/2010
Last updated
06/23/2026
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