Individual provider · Type 1 NPI

Nicole Tiderencel, CTRS

Recreation Therapist · Kennesaw, GA

NPI number 1881114841 Active

Practice location

1291 Stanley Rd NW
Kennesaw, GA 30152-4359

Call (770) 427-0147 Map

Specialties and licenses

TaxonomyCodeLicense
Recreation Therapist Primary 225800000X48030 (GA)

Recreation Therapist: A recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in that behavior and promote the growth and development of the patient.

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About NPI 1881114841

Nicole Tiderencel, CTRS's National Provider Identifier is 1881114841, issued on Jun 21, 2017. The primary taxonomy on file is Recreation Therapist (225800000X), and the practice location is in Kennesaw, GA. The record was last updated on Jun 21, 2017.