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Individual

DR. MICHAEL DE VIDAS

Active
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Individual

DR. MICHAEL DE VIDAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DSW, LCSW

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
034600-1R
NY
104100000X
Social Worker
44SC05214500
NJ

Other

Enumeration date
12/27/2007
Last updated
12/27/2007
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