Provider Demographics
NPI:1114628906
Name:WASHINGTON, BRIDGETT MACHELE
Entity Type:Individual
Prefix:
First Name:BRIDGETT
Middle Name:MACHELE
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6608 SWEET GUM CT.
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117
Mailing Address - Country:US
Mailing Address - Phone:334-329-8405
Mailing Address - Fax:334-329-8405
Practice Address - Street 1:6608 SWEET GUM CT.
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117
Practice Address - Country:US
Practice Address - Phone:334-329-8405
Practice Address - Fax:334-329-8405
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-17
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health