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General NPI Number Information
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NPI Number | 1942145412
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Entity Type | Organization
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Legal Business Name | BRIDGE AND ROOTS COUNSELING LLC
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Dates
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Enumeration Date | 04/21/2026
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Last Update Date | 04/21/2026
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Provider Practice Location Address
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Address Line | 1710 MACARTHUR RD STE 351
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City | WHITEHALL
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State | PA
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Zip | 18052-5734
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Country | US
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Telephone | 484-222-0541
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Fax |
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Provider Business Mailing Address
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Address Line | 1710 MACARTHUR RD STE 351
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City | WHITEHALL
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State | PA
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Zip | 18052-5734
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Country | US
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Telephone | 484-222-0541
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA ALLEGRA OQUENDO
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Credential | LPC, NCC
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Telephone | 904-451-1505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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