Individual
MR. KEVIN RICHARD BIDINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SAC-IT
Contact information
Practice address
810 W OLIN AVE, MADISON, WI 53715-2142
(608) 255-5922
(608) 255-0340
Mailing address
810 W OLIN AVE, MADISON, WI 53715-2142
(608) 255-5922
(608) 255-0340
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16954-130
WI
324500000X
Substance Abuse Rehabilitation Facility
16954-130
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417112780
—
WI
Enumeration date
09/16/2013
Last updated
09/16/2013
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