Individual
ANGELA TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3601 NAUGATUCK CIR, LAS VEGAS, NV 89129-6528
(702) 834-8515
Mailing address
3601 NAUGATUCK CIR, LAS VEGAS, NV 89129-6528
(702) 834-8515
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/23/2011
Last updated
03/06/2012
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