Provider Demographics
NPI:1952521486
Name:MADDEN, BRIDGET ANN (CM-A, BHRS)
Entity Type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:ANN
Last Name:MADDEN
Suffix:
Gender:F
Credentials:CM-A, BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 S YORKTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5326
Mailing Address - Country:US
Mailing Address - Phone:918-688-2978
Mailing Address - Fax:918-227-1125
Practice Address - Street 1:1722 S YORKTOWN AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5326
Practice Address - Country:US
Practice Address - Phone:918-688-2978
Practice Address - Fax:918-227-1125
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor