Individual
MS. ASHLEY ANDREA TISDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1519 JOHNSON FERRY RD STE 100, MARIETTA, GA 30062-6410
(866) 523-4268
Mailing address
PO BOX 399318, SAN FRANCISCO, CA 94139-9318
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/26/2021
Last updated
05/26/2021
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