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Individual

MR. WIDNER ALEXANDRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LADC I

Contact information

Practice address
263 EUSTIS ST, BOSTON, MA 02119-2826
(617) 445-1123
Mailing address
133 ADDISON ST, BROCKTON, MA 02301-1403
(857) 236-8190

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
23160
MA

Other

Enumeration date
11/30/2023
Last updated
11/30/2023
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