Individual
DR. CAROLE ANNE WIDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.
Contact information
Practice address
110 2ND ST S STE 301, WAITE PARK, MN 56387-1314
(320) 252-2976
(320) 656-1570
Mailing address
110 2ND ST S STE 301, WAITE PARK, MN 56387-1314
(320) 252-2976
(320) 656-1570
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
LP1899
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
491351500
—
MN
Enumeration date
07/17/2006
Last updated
05/14/2008
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