Individual
JOHNSTON HAMMOND TISDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, NCC
Contact information
Practice address
219 E WILLOW GROVE AVE APT L2, PHILADELPHIA, PA 19118-2929
(251) 504-0860
Mailing address
219 E WILLOW GROVE AVE APT L2, PHILADELPHIA, PA 19118-2929
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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