Individual
MRS. DAWN MARIE TISDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1021 BROADWAY ST FL 5, BUFFALO, NY 14212-1460
(716) 803-3131
Mailing address
1021 BROADWAY ST FL 5, BUFFALO, NY 14212-1460
(716) 803-3131
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/16/2022
Last updated
03/16/2022
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