Provider Demographics
NPI:1841951779
Name:BRIDGES, ADAM (RBT)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:BRIDGES
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1964 ASHLEY RIVER RD STE B
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-4782
Mailing Address - Country:US
Mailing Address - Phone:252-908-0575
Mailing Address - Fax:888-808-4249
Practice Address - Street 1:1964 ASHLEY RIVER RD STE B
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4782
Practice Address - Country:US
Practice Address - Phone:252-908-0575
Practice Address - Fax:888-808-4249
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician