Individual
MS. ZYNYA RICHELL TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DP-CPRM
Contact information
Practice address
4875 COPLIN ST, DETROIT, MI 48215-2192
(313) 822-1135
(313) 822-1157
Mailing address
26450 CROCKER BLVD APT 1104, HARRISON TOWNSHIP, MI 48045-2497
(313) 753-4470
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/27/2024
Last updated
02/27/2024
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