Individual
KENNA MARIE TIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CBD
Contact information
Practice address
945 MCWHORTER RD, STEPHENS, GA 30667-1806
(678) 982-9038
(678) 982-9038
Mailing address
945 MCWHORTER RD, STEPHENS, GA 30667-1806
(678) 982-9038
(678) 982-9038
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
BD41703
GA
Other
Enumeration date
01/29/2026
Last updated
01/29/2026
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