Individual
DONNA JEANNE VIDALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14508 OWEN TECH BLVD APT 316, AUSTIN, TX 78728-0007
(361) 648-5280
Mailing address
14508 OWEN TECH BLVD APT 316, AUSTIN, TX 78728-0007
(361) 648-5280
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
14641
TX
Other
Enumeration date
11/22/2021
Last updated
11/22/2021
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