Individual
NOELIKA ANN RAQUEL VIDAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
1393 BAILEY ST, HANFORD, CA 93230-5922
(559) 582-4481
Mailing address
32164 BIG CREEK CT, VISALIA, CA 93291-7742
(559) 350-4761
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
40813
CA
Other
Enumeration date
05/16/2024
Last updated
05/16/2024
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