MR. William Cleveland Tidwell JR., LPC

NPI #1326114448 in Bremen, Georgia

Provider Information

NPI Number: 1326114448
Entity Type: Individual
Name: MR. William Cleveland Tidwell JR., LPC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Credential: LPC
Enumeration Date: Nov 28, 2006
Last Updated: Jun 23, 2008

Practice Location

Address: 405 ALABAMA AVENUE
City: Bremen
State: Georgia
ZIP Code: 30110
Phone: (770) 537-2367

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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