Individual provider · Type 1 NPI

Khalia Tidwell

Addiction (Substance Use Disorder) Counselor · Portland, OR

NPI number 1326874017 Active

Practice location

6923 N Fessenden St Apt E
Portland, OR 97203-1894

Call (971) 258-5803 Map

Mailing address

8915 SW Center St
Portland, OR 97223-6307

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800XNone listed
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1326874017

Khalia Tidwell's National Provider Identifier is 1326874017, issued on Sep 10, 2024. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Portland, OR. The record was last updated on Sep 23, 2024.