Organization
WESTERN PLAINS PSYCHOLOGY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE WHITE-VIDLAK PH.D. (OWER/PRES.)
(308) 630-7966
Entity
Organization
Contact information
Practice address
3911 AVE B, SUITE 3400, SOUTH PLAZA, SCOTTSBLUFF, NE 69361
(308) 630-7966
(308) 630-1028
Mailing address
P.O. BOX 1367, SCOTTSBLUFF, NE 69363-1367
(308) 630-7966
(308) 630-1028
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
605
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025891800
—
NE
Enumeration date
10/25/2010
Last updated
10/25/2010
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