Individual
MARY C TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
401 S BOSTON AVE STE 500-5, TULSA, OK 74103-4016
(918) 641-4750
Mailing address
401 S BOSTON AVE STE 500-5, TULSA, OK 74103-4016
(918) 641-4750
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10926
OK
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
06/27/2020
Last updated
02/16/2023
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