| 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 |