Individual provider · Type 1 NPI

Shelby O. Tidwell, BA, PSRS

Mental Health Counselor · Ada, OK

NPI number 1255658944 Active

Practice location

1201 Arlington St Ste G
Ada, OK 74820-4072

Fax (580) 310-6047

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1255658944

Shelby O. Tidwell, BA, PSRS's National Provider Identifier is 1255658944, issued on Apr 21, 2010. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Ada, OK. The record was last updated on Apr 21, 2010.