Jada Tidwell PH.D

NPI 1629292768 - Psychologist - 103TC1900X

NPI Details
NPI 1629292768
Gender Female
Enumeration Date 04/12/2007
Last Updated 03/06/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
STE 105
DECATUR GA, 30030-3330, US
Phone (404) 797-0889
Fax (404) 378-2039
Business Location
DECATUR GA, 30030-4617, US
Phone (404) 797-0889
Fax (404) 378-2039
Taxonomy Code 103TC1900X
License State Georgia
License Number PSY002640
Remove 1629292768 NPI Number

According to our database, Dr. Jada Tidwell PH.D NPI is 1629292768, taxonomy code is 103TC1900X and license number is PSY002640, license state is located at Georgia. Jada Tidwell PH.D physically located at 215 Church St, Decatur GA, 30030-3330. NPI Number Jada Tidwell PH.D has the Individual type.

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1629292768 NPI number is provided on an as is basis without warranty of any kind. 1629292768 is maintained by the National Plan & Provider Enumeration System. The contents of Jada Tidwell PH.D are for informational purposes only.