Provider Demographics
NPI:1497155964
Name:PERRY, BRIDGET (PHD)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 MONA TER
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6423
Mailing Address - Country:US
Mailing Address - Phone:203-615-4252
Mailing Address - Fax:
Practice Address - Street 1:1275 POST RD
Practice Address - Street 2:SUITE 200C
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6015
Practice Address - Country:US
Practice Address - Phone:203-615-4252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003393103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist