Individual
TONYA TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
800 EXCHANGE AVE STE 103, CONWAY, AR 72032-7833
(501) 781-2230
(870) 972-4911
Mailing address
35 GOFF ST, VILONIA, AR 72173-9315
(479) 567-1858
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A2205009
AR
101YP2500X
Professional Counselor
P2508009
AR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
10/11/2012
Last updated
08/21/2025
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