Doctor Name: | MRS. ANDREA JEANNE VIDRINE |
NPI Number: | 1467629030 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 8145 |
Business Practice Address: | 130 S 3rd St Eunice, LA - 705354614 |
Business Phone Number: | 3374573000 |
Business Fax Number: | 3374573055 |
Mailing Address: | 130 S 3rd St, EUNICE |
State: | LA |
Postal Code: | 705354614 |
Phone Number: | 3374573000 |
Fax Number: | 3374573055 |
NPI Enumeration Date: | 05/13/2008 |
NPI Last Update Date: | 09/14/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 8145 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |