Carla Tisdale
NPI #1568060077 in La Grange Park, Illinois
Provider Information
- NPI Number
- 1568060077
- Entity Type
- Individual
- Name
- Carla Tisdale
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Behavior Technician
- Enumeration Date
- Oct 16, 2020
- Last Updated
- Oct 16, 2020
Practice Location
- Address
- 306 N KENSINGTON AVE
- City
- La Grange Park
- State
- Illinois
- ZIP Code
- 60526-1870
- Phone
- (312) 965-2997
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
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