NPI | 1922247832 |
---|---|
Other Name | KIMBERLY BRIDGMON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 4727) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO LPC-4727) |
Enumeration Date | 2009-02-17 |
Last Update Date | 2011-11-22 |