Tidwell, Tabitha Lynnae

Tidwell, Tabitha Lynnae is an individual health care provider with primary practice located at 5300 Angeles Vista Blvd , View Park CA 90043-1648. She recently has 3 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Marriage & Family Therapist is her primary health care specialty. Tidwell, Tabitha Lynnae can be contacted via phone (323) 295-4555.

Contact Information

Primary practice address
5300 Angeles Vista Blvd View Park CA 90043-1648
Phone: (323) 295-4555
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X

Profile Details

NPI number 1497344170
LBN Legal business name Tidwell, Tabitha Lynnae
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 15th, 2021
Last updated Sep 19th, 2022 - about 2 years ago

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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