Provider Demographics
NPI:1255164927
Name:BRIDGER PLLC
Entity type:Organization
Organization Name:BRIDGER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:OYEWOLE-TONEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-319-9710
Mailing Address - Street 1:8954 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BEULAH
Mailing Address - State:CO
Mailing Address - Zip Code:81023-9765
Mailing Address - Country:US
Mailing Address - Phone:303-319-9710
Mailing Address - Fax:
Practice Address - Street 1:8954 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BEULAH
Practice Address - State:CO
Practice Address - Zip Code:81023-9765
Practice Address - Country:US
Practice Address - Phone:303-319-9710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty