Provider Demographics
NPI:1649239039
Name:VIDONI, VIRINIA EVE (MA)
Entity type:Individual
Prefix:MRS
First Name:VIRINIA
Middle Name:EVE
Last Name:VIDONI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1736 CENTRAL PARK
Mailing Address - Street 2:
Mailing Address - City:OREFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:18069-8907
Mailing Address - Country:US
Mailing Address - Phone:610-366-9201
Mailing Address - Fax:610-366-7739
Practice Address - Street 1:4825 W TILGHMAN ST
Practice Address - Street 2:SUITE 104
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9322
Practice Address - Country:US
Practice Address - Phone:610-366-9201
Practice Address - Fax:610-366-7739
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006181L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling