Healthcare Provider Details

I. General information

NPI: 1982596169
Provider Name (Legal Business Name): BRIDGE INTEGRATIVE HEALTH AND NUTRITION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4316 ALABAMA AVE SE
WASHINGTON DC
20019-3001
US

IV. Provider business mailing address

PO BOX 15116
WASHINGTON DC
20003-0116
US

V. Phone/Fax

Practice location:
  • Phone: 302-536-9355
  • Fax: 866-406-7798
Mailing address:
  • Phone: 302-536-9355
  • Fax: 866-406-7798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EMILY ANN BROWN
Title or Position: FOUNDER AND PRINCIPAL MANAGER
Credential: MS, CNS, LDN
Phone: 302-536-9355