Individual
MARCIA TIDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
9757 W 343RD ST, PAOLA, KS 66071-6269
(913) 271-3736
Mailing address
9757 W 343RD ST, PAOLA, KS 66071-6269
(913) 271-3736
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
17-02010
KS
225X00000X
Occupational Therapist
2001007559
MO
Other
Enumeration date
12/17/2014
Last updated
12/17/2014
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