Individual
MS. ANNE A VIDACOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
446 W NORTHGATE DR, IRVING, TX 75062-3616
(214) 597-3575
Mailing address
446 W NORTHGATE DR, IRVING, TX 75062-3616
(214) 597-3575
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
14070
TX
Other
Enumeration date
08/25/2009
Last updated
08/25/2009
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