Individual
LISA BIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
415 ROBERTS CEMETERY RD, WEWAHITCHKA, FL 32465-7737
(850) 273-8222
Mailing address
415 ROBERTS CEMETERY RD, WEWAHITCHKA, FL 32465-7737
(850) 273-8222
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TS0200X
School Psychologist
Primary
SS1264
FL
Other
Enumeration date
06/03/2014
Last updated
04/05/2023
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