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Individual

MS. KRISTINA JOAN TIDWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APCC

Contact information

Practice address
200 IKE DR, MAKAWAO, HI 96768-9718
(808) 316-9600
Mailing address
70 CENTRAL AVE STE 6, WAILUKU, HI 96793-1701
(909) 708-5106

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
14095
CA
101YM0800X
Mental Health Counselor
Primary
HI

Other

Enumeration date
01/09/2024
Last updated
05/29/2025
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