Individual
JENISE ELAINE TIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICDC-CS
Contact information
Practice address
865 S PATTERSON BLVD, DAYTON, OH 45402-2624
(937) 966-4673
Mailing address
100 CROWNE POINT PL, CINCINNATI, OH 45241-5427
(513) 743-7628
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
161533
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LICDC.161533
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Enumeration date
12/07/2017
Last updated
02/16/2024
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