NICHOLAS MACKENZIE BRIDGETT

CHAMPAIGN, IL
NPI1306858592
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IL  149010226)
Enumeration Date2006-08-13
Last Update Date2007-07-08
Business Address
Mr. NICHOLAS MACKENZIE BRIDGETT LCSW
1801 FOX DR
CHAMPAIGN, IL 61820-7236
Phone number: 217-417-6432
Mailing Address
Mr. NICHOLAS MACKENZIE BRIDGETT LCSW
1801 FOX DR
CHAMPAIGN, IL 61820-7236
Phone number: 217-417-6432
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