Individual
KATHRYN DAVIS TIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
815 37TH AVE S, MOORHEAD, MN 56560-5524
(701) 451-4811
(651) 925-0057
Mailing address
PO BOX 9859, FARGO, ND 58106-9859
(701) 451-4900
(651) 925-0057
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
28095
MN
1041C0700X
Clinical Social Worker
5057
ND
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
06/03/2014
Last updated
01/21/2021
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