Tidwell, Derrell R.
Tidwell, Derrell R. is an sole proprietor health care provider with primary practice located at 432 30Th Street , Port Townsend WA 98368. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Tidwell, Derrell R. can be contacted via phone (310) 670-4295.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 9609 | California |
Profile Details
| NPI number | 1871661074 |
|---|---|
| LBN Legal business name | Tidwell, Derrell R. |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 4th, 2006 |
| Last updated | Feb 14th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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