Individual
EMILY JANE TISDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1203 US HIGHWAY 98 STE 2A9, DAPHNE, AL 36526
(314) 920-1828
(251) 243-0984
Mailing address
1203 US HIGHWAY 98 STE 2A9, DAPHNE, AL 36526-3901
(314) 920-1828
(251) 243-0984
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
0-14-6203
AL
103K00000X
Behavior Analyst
Primary
1-18-33094
AL
Other
Enumeration date
12/04/2017
Last updated
08/19/2019
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