Healthcare Provider Details

I. General information

NPI: 1740008671
Provider Name (Legal Business Name): BRIDGETTE TRUE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 W MAIN ST
LEBANON TN
37087-3402
US

IV. Provider business mailing address

7024 TIMBER OAK DR
MT JULIET TN
37122-6358
US

V. Phone/Fax

Practice location:
  • Phone: 615-784-9209
  • Fax:
Mailing address:
  • Phone: 310-562-1277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: