Individual
ANGELA TATUM KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
935 HWY VV, KENNETT, MO 63857-0071
(573) 888-5925
(573) 888-9365
Mailing address
PO BOX 63857, 935 HWY VV, KENNETT, MO 63857
(573) 888-6925
(573) 888-9365
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/17/2015
Last updated
12/17/2015
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