Individual
BREANNA TIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
310 WHITTINGTON AVE, HOT SPRINGS, AR 71901-3406
(501) 623-3477
(501) 624-7498
Mailing address
310 WHITTINGTON AVE, HOT SPRINGS, AR 71901-3406
(501) 623-3477
(501) 624-7498
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
AR
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/14/2020
Last updated
11/22/2023
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