Individual
JILL VIDAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5377 MANHATTAN CIR, SUITE 201, BOULDER, CO 80303-4333
(720) 304-0083
(720) 304-0114
Mailing address
5377 MANHATTAN CIR, SUITE 201, BOULDER, CO 80303-4333
(720) 304-0083
(720) 304-0114
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
40563
CO
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
40563
CO
Other
Enumeration date
07/20/2006
Last updated
08/01/2013
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