Provider Demographics
NPI:1477730133
Name:LANGER, BRIDGET (MS)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:LANGER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3073 S CHASE AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-2667
Mailing Address - Country:US
Mailing Address - Phone:414-231-4021
Mailing Address - Fax:414-489-0540
Practice Address - Street 1:3073 S CHASE AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-2667
Practice Address - Country:US
Practice Address - Phone:414-231-4021
Practice Address - Fax:414-489-0540
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4270-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional