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Individual

MR. ASHTON C VIDRINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN, PMHNP-BC, LMSW

Contact information

Practice address
689 E AIRPORT AVE STE 3, BATON ROUGE, LA 70806-6557
(225) 268-1412
Mailing address
689 E AIRPORT AVE STE 3, BATON ROUGE, LA 70806-6557
(225) 268-1412

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
12373
LA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
202801
LA

Other

Enumeration date
05/09/2024
Last updated
08/05/2025
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