Individual
DR. DESIRAE NICOLLE VIDAURRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2400 CANAL ST, NEW ORLEANS, LA 70119-6535
(504) 507-2000
Mailing address
144 ELK PL APT 1507, NEW ORLEANS, LA 70112-2636
(512) 538-8051
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810005697
VA
Other
Enumeration date
06/02/2017
Last updated
06/02/2017
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