Individual
COURTNEY TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
510 PRINCESS ANNE ST STE 101, FREDERICKSBURG, VA 22401-6077
(540) 693-0096
Mailing address
820 ABBERLY DR APT 104, STAFFORD, VA 22554-6562
(703) 927-1684
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701006751
VA
Other
Enumeration date
04/29/2019
Last updated
04/29/2019
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