Individual
ANDREA DOERMANN TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
1371 N 180 W, LEHI, UT 84043-1165
(801) 310-0188
Mailing address
1371 N 180 W, LEHI, UT 84043-1165
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
453274
UT
Other
Enumeration date
09/07/2024
Last updated
09/07/2024
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