Provider Demographics
NPI:1568681948
Name:BRIDENBAUGH, AHNA E (LAC)
Entity Type:Individual
Prefix:
First Name:AHNA
Middle Name:E
Last Name:BRIDENBAUGH
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2155 W STATE ROUTE 89A STE 114
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-5445
Mailing Address - Country:US
Mailing Address - Phone:928-239-9706
Mailing Address - Fax:928-282-2895
Practice Address - Street 1:2155 W STATE ROUTE 89A STE 114
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5445
Practice Address - Country:US
Practice Address - Phone:928-239-9706
Practice Address - Fax:928-239-9716
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0006171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist