Provider Demographics
NPI:1205506235
Name:NDICHIA, TILDER KUMICHII (RESPITE WORKER)
Entity type:Individual
Prefix:MS
First Name:TILDER
Middle Name:KUMICHII
Last Name:NDICHIA
Suffix:
Gender:F
Credentials:RESPITE WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 DONNA AVE
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-2884
Mailing Address - Country:US
Mailing Address - Phone:240-784-3841
Mailing Address - Fax:
Practice Address - Street 1:65 WOODS EDGE RD UNIT 6
Practice Address - Street 2:
Practice Address - City:FORT ASHBY
Practice Address - State:WV
Practice Address - Zip Code:26719-9292
Practice Address - Country:US
Practice Address - Phone:240-784-3841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker