MR. Michael A Tisdale, CP00003857

NPI #1831414796 in Elma, Washington

Provider Information

NPI Number
1831414796
Entity Type
Individual
Name
MR. Michael A Tisdale, CP00003857
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Counselor - Addiction (Substance Use Disorder)
Credential
CP00003857
Enumeration Date
Apr 5, 2010
Last Updated
Apr 5, 2010

Practice Location

Address
308 E. YOUNG ST.
City
Elma
ZIP Code
98541
Phone
(360) 482-2674

Specialties & Taxonomy Codes

Specialty
Counselor - Addiction (Substance Use Disorder)Addiction (Substance Use Disorder)

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