Provider Demographics
NPI:1134695398
Name:BRIDGES, ANGELA SANDERS (RSW, MSW)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:SANDERS
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:RSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2313 EASTMERE ST
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-2214
Mailing Address - Country:US
Mailing Address - Phone:504-347-0961
Mailing Address - Fax:
Practice Address - Street 1:4700 WICHERS DR
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3041
Practice Address - Country:US
Practice Address - Phone:504-319-1769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7589104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker