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General NPI Number Information
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NPI Number | 1649239039
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Entity Type | Individual
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Provider Name | VIRINIA EVE VIDONI M.A.
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Gender | Female
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4825 W TILGHMAN ST SUITE 104
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City | ALLENTOWN
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State | PA
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Zip | 18104-9322
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Country | US
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Telephone | 610-366-9201
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Fax | 610-366-7739
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Provider Business Mailing Address
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Address Line | 1736 CENTRAL PARK
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City | OREFIELD
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State | PA
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Zip | 18069-8907
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Country | US
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Telephone | 610-366-9201
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Fax | 610-366-7739
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PS006181L
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License Number State | PA
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