Individual
MS. AMY MARIE VIDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC, LPAT, ATR-BC
Contact information
Practice address
2450 ALAMO AVE SE, ALBUQUERQUE, NM 87106-3204
(505) 925-2489
Mailing address
933 BRADBURY DR SE, SUITE 2222, ALBUQUERQUE, NM 87106-4374
(505) 272-3120
(505) 272-8060
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0099801
NM
Other
Enumeration date
12/22/2006
Last updated
06/05/2012
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