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General NPI Number Information
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NPI Number | 1154162675
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Entity Type | Organization
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Legal Business Name | BRIDGET MILLER THERAPY, LLC
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Dates
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Enumeration Date | 06/06/2024
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 317 N MAIN ST
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City | NATICK
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State | MA
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Zip | 01760
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Country | US
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Telephone | 617-286-2142
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Fax |
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Provider Business Mailing Address
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Address Line | 64 BURTON ST
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City | BRIGHTON
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State | MA
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Zip | 02135-1532
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRIDGET MILLER
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Credential | LICSW
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Telephone | 617-286-2142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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