Provider Demographics
NPI:1003704511
Name:BRIDGE ABA
Entity type:Organization
Organization Name:BRIDGE ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:YASMIN
Authorized Official - Middle Name:ABDULRISAK
Authorized Official - Last Name:IGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-338-2479
Mailing Address - Street 1:8400 NORMANDALE LAKE BLVD STE 920
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55437-3843
Mailing Address - Country:US
Mailing Address - Phone:206-338-2497
Mailing Address - Fax:206-848-5275
Practice Address - Street 1:8400 NORMANDALE LAKE BLVD STE 920
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55437-3843
Practice Address - Country:US
Practice Address - Phone:206-338-2497
Practice Address - Fax:206-848-5275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency