Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
NICOLE TIDERENCEL, CTRS
ActiveNICOLE TIDERENCEL, CTRS is a Recreation Therapist healthcare provider located in KENNESAW, Georgia. NPI 1881114841 is currently active in the NPPES registry. Verify at CMS.
Recreation Therapist · KENNESAW, GA
Registration Details
- NPI Number
- 1881114841
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 21, 2017 (9.1102627740572 yrs)
- Last Updated
- Jun 21, 2017
- License
-
48030 (GA)
Practice Information
- Address
-
1291 STANLEY RD NWKENNESAW, GA, 301524359Browse GA providers · Browse ZIP 30152
- Phone
- 7704270147
- Primary Specialty
-
Recreation Therapist
225800000X
Other Recreation Therapist Providers in KENNESAW, GA
| Name | Credential | NPI |
|---|---|---|
| EBONY ELBERT | CTRS | 1528588571 |
| DAVID MONDECAR | — | 1609396662 |
| PATRICE M PUSHA | — | 1346729845 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.