Healthcare Provider Details

I. General information

NPI: 1750107728
Provider Name (Legal Business Name): BRIDGET CARDENAS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRIDGET MANION OTR/L

II. Dates (important events)

Enumeration Date: 11/25/2024
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1244 LOBO PL NE
ALBUQUERQUE NM
87106-2611
US

IV. Provider business mailing address

1244 LOBO PL NE
ALBUQUERQUE NM
87106-2611
US

V. Phone/Fax

Practice location:
  • Phone: 218-391-9448
  • Fax:
Mailing address:
  • Phone: 218-391-9448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT4620
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT4620
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: