Provider Demographics
NPI:1013326685
Name:MOSTEK, BRIDGET DANIELLE (LIMHP)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:DANIELLE
Last Name:MOSTEK
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 PRAIRIE VIEW PL
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-8300
Mailing Address - Country:US
Mailing Address - Phone:308-865-2249
Mailing Address - Fax:308-865-2931
Practice Address - Street 1:1755 PRAIRIE VIEW PL
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-8300
Practice Address - Country:US
Practice Address - Phone:308-865-2249
Practice Address - Fax:308-865-2931
Is Sole Proprietor?:No
Enumeration Date:2014-08-07
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4226101YM0800X
NE1283101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health