Provider Demographics
NPI:1619114550
Name:ALDEA, BERNADETTE (RPT)
Entity Type:Individual
Prefix:MS
First Name:BERNADETTE
Middle Name:
Last Name:ALDEA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 HAWKSMOORE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-3628
Mailing Address - Country:US
Mailing Address - Phone:586-884-6551
Mailing Address - Fax:586-884-6552
Practice Address - Street 1:G4007 W COURT ST
Practice Address - Street 2:SUITE #G2
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3560
Practice Address - Country:US
Practice Address - Phone:810-230-0444
Practice Address - Fax:810-230-0747
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501013210225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist