Vidal, Brenda Ann
Vidal, Brenda Ann is an sole proprietor health care provider with primary practice located at 6441 Jefferson Pike , Frederick MD 21703-7039. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Vidal, Brenda Ann can be contacted via phone (301) 668-6033.Contact Information
Primary practice address
6441 Jefferson Pike
Frederick MD 21703-7039
Phone: (301) 668-6033
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 04302 | Maryland |
Profile Details
| NPI number | 1649363037 |
|---|---|
| LBN Legal business name | Vidal, Brenda Ann |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 30th, 2006 |
| Last updated | Apr 28th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649363037 | NPPES |
| Delaware | Other | P00384922 | RR MEDICARE S |
| Delaware | MEDICAID | 412389100 | RR MEDICARE S |
| Delaware | Other | 60484701 | RR MEDICARE S |
| Delaware | Other | G3960046 | RR MEDICARE S |
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