Individual
ANITA TISDALE
Active
Individual
ANITA TISDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2173
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3645749
—
TN
01
—
4111152
BLUE CROSS BLUE SHIELD
TN
Enumeration date
04/11/2006
Last updated
07/13/2026
Update your record
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