Individual
ARIE TISDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
107 WATERVILLE DR, COLUMBIA, SC 29229-8142
(839) 246-6777
Mailing address
107 WATERVILLE DR, COLUMBIA, SC 29229-8142
(839) 246-6777
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/06/2026
Last updated
07/06/2026
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