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1962760918
KIM MARY BRIDGWOOD
SMITHTOWN, NY
NPI
1962760918
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY 0744541)
Enumeration Date
2012-04-27
Last Update Date
2012-04-27
Business Address
-- KIM MARY BRIDGWOOD LCSW
732 SMITHTOWN BYP STE A55
SMITHTOWN, NY 11787-5020
Phone number: 631-320-1070
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Mailing Address
-- KIM MARY BRIDGWOOD LCSW
20 CECILY LN
COMMACK, NY 11725-3302
Phone number: 163-149-9032
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