Individual
JAMIE VIDRINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCD CCC/SLP
Contact information
Practice address
170 HIGHWAY 363, WASHINGTON, LA 70589-4501
(337) 849-5448
Mailing address
170 HIGHWAY 363, WASHINGTON, LA 70589-4501
(337) 849-5448
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5883
LA
Other
Enumeration date
10/10/2014
Last updated
10/10/2014
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