IndividualActive
Alicia Tisdale, PHD
NPI 1083622914 · Psychologist · West Bloomfield, MI
Provider details
- NPI number
- 1083622914
- Entity type
- Individual
- Primary specialty
- PsychologistBehavioral Health & Social Service Providers
- Credential
- PHD
- Sex
- Female
- Sole proprietor
- No
- License
- 6301003007 (MI)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Practice location
5101 Willow Pond Drive
West Bloomfield, MI 48323
Phone: (248) 974-1783
Approximate (ZIP-level) locationGet directions
Mailing address
5101 Willow Pond Dr
West Bloomfield, MI 48323-2094
Registry dates
- Enumerated
- 2006-08-04
- Last updated
- 2025-10-30
- Certified
- 2025-10-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.