Individual
MS. AMY VALENTINE TIDIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA,CCC-SP
Contact information
Practice address
1130 GROVE ST, SAN LUIS OBISPO, CA 93401-2914
(805) 543-3945
Mailing address
5875 SALISBURY LN, SAN LUIS OBISPO, CA 93401-8267
(805) 459-5775
(805) 543-3121
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
15475
CA
Other
Enumeration date
08/27/2010
Last updated
08/27/2010
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