Provider Demographics
NPI:1194377945
Name:DILWORTH, BRIDGETTE LEMOR (LPC)
Entity Type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:LEMOR
Last Name:DILWORTH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BRIDGETTE
Other - Middle Name:LEMOR
Other - Last Name:DILWORTH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:2319 GOLDEN BRANDY LN
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77469-4694
Mailing Address - Country:US
Mailing Address - Phone:281-904-3503
Mailing Address - Fax:
Practice Address - Street 1:2319 GOLDEN BRANDY LN
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77469-4694
Practice Address - Country:US
Practice Address - Phone:281-904-3503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78717101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health