Individual
MR. ANDREW ROBESON TIDRICK
Active
Individual
MR. ANDREW ROBESON TIDRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
09923286
CO
1041C0700X
Clinical Social Worker
27843
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040521902
—
TX
01
—
09923286
COLORADO LCSW
CO
01
—
11964870
CAQH
—
Enumeration date
01/08/2007
Last updated
10/28/2013
Update your record
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