Individual
MARIA VIDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
230 W KINGS AVE, PHOENIX, AZ 85023-7502
(480) 242-3428
Mailing address
230 W KINGS AVE, PHOENIX, AZ 85023-7502
(480) 242-3428
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN199848
AZ
Other
Enumeration date
05/24/2023
Last updated
05/24/2023
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