Individual
NICHOLAUS E WIDING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
7066 STILLWATER BLVD N, OAKDALE, MN 55128-3937
(651) 777-5222
(651) 251-5111
Mailing address
7066 STILLWATER BLVD N, OAKDALE, MN 55128-3937
(651) 777-5222
(651) 251-5111
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302362
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57422KU
BLUE CROSS/BLUE SHIELD
MN
Enumeration date
11/03/2008
Last updated
11/03/2008
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