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Individual

ALYSON TIDWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5665 NEW FORSYTH RD, MACON, GA 31210-5770
(478) 238-5757
Mailing address
1001 WALNUT ST UNIT A, MACON, GA 31201-1904
(478) 954-9631

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
09/18/2025
Last updated
09/18/2025
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