Healthcare Provider Details

I. General information

NPI: 1710648845
Provider Name (Legal Business Name): BRIDGET KUZMA MPS, LCAT, ATR-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2021
Last Update Date: 12/30/2021
Certification Date: 10/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10139 CEDAR LN
KENSINGTON MD
20895-3844
US

IV. Provider business mailing address

10139 CEDAR LN
KENSINGTON MD
20895-3844
US

V. Phone/Fax

Practice location:
  • Phone: 301-785-1720
  • Fax:
Mailing address:
  • Phone: 301-785-1720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number002575-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: