Provider Demographics
NPI:1548546690
Name:VIDES, ZAHIDA Y
Entity type:Individual
Prefix:
First Name:ZAHIDA
Middle Name:Y
Last Name:VIDES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 DANA AVE
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-3435
Mailing Address - Country:US
Mailing Address - Phone:617-717-8067
Mailing Address - Fax:617-361-8218
Practice Address - Street 1:160 DANA AVE
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:MA
Practice Address - Zip Code:02136-3435
Practice Address - Country:US
Practice Address - Phone:617-717-8067
Practice Address - Fax:617-361-8218
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor