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Individual
ALEXANDER WIDAS
Active
Individual
ALEXANDER WIDAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS, LMT, CHT, REV
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
097.0135085
VT
101YP1600X
Pastoral Counselor
—
—
225700000X
Massage Therapist
164.0000760
VT
225700000X
Massage Therapist
MT.0024401
CO
Other
Enumeration date
06/29/2022
Last updated
11/07/2022
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