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Individual

MRS. BRENDA VIDAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS

Contact information

Practice address
817 N DIXIE HWY, POMPANO BEACH, FL 33060-5621
(954) 785-8285
(954) 928-0040
Mailing address
5783 N.W VENITH DRIVE, PORT ST LUCIE, FL 34986-3529
(754) 368-3554

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
N/A
N/A
Enumeration date
06/29/2012
Last updated
06/29/2012
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