Provider Demographics
NPI:1497007959
Name:BRIDE, BRIGET (PSYCHOTHERAPIST)
Entity Type:Individual
Prefix:
First Name:BRIGET
Middle Name:
Last Name:BRIDE
Suffix:
Gender:F
Credentials:PSYCHOTHERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 DARRELL DR
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4810
Mailing Address - Country:US
Mailing Address - Phone:781-961-5658
Mailing Address - Fax:
Practice Address - Street 1:14 DARRELL DR
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-4810
Practice Address - Country:US
Practice Address - Phone:781-961-5658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor