MS. Carol Tidwell, MS. LCPC

NPI #1003250754 in Eagle, Idaho

Provider Information

NPI Number: 1003250754
Entity Type: Individual
Name: MS. Carol Tidwell, MS. LCPC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Mental Health
Credential: MS. LCPC
Enumeration Date: Apr 24, 2013
Last Updated: Jun 5, 2023

Practice Location

Address: 225 S LINDER RD APT A308
City: Eagle
State: Idaho
ZIP Code: 83616-4421
Phone: (208) 546-1808

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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