Individual
MICHAEL VIDANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1715 TOWER DR W STE 100, STILLWATER, MN 55082-7609
(651) 390-5001
Mailing address
1900 SILVER LAKE RD NW, NEW BRIGHTON, MN 55112-1786
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
10/05/2021
Last updated
10/05/2021
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