Healthcare Provider Details

I. General information

NPI: 1306775697
Provider Name (Legal Business Name): BRIDGETTE L ALAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26657 WOODWARD AVE STE 100
HUNTINGTON WOODS MI
48070-1300
US

IV. Provider business mailing address

55334 LEONARD CT
SHELBY TOWNSHIP MI
48316-5321
US

V. Phone/Fax

Practice location:
  • Phone: 248-572-3390
  • Fax:
Mailing address:
  • Phone: 586-764-9392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6451024962
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: