| NPI | 1306464516 |
|---|---|
| Former Name | BRIDGET DEVOTA ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2023000631) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IA 099966) |
| 1041C0700X Social Worker, Clinical (Licence: MO 2020025791) | |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2024-02-13 |