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General NPI Number Information
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NPI Number | 1982358578
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Entity Type | Organization
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Legal Business Name | BRIDGE THE JOURNEY, LLC
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Dates
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Enumeration Date | 02/11/2022
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 5534 OLD NATIONAL HIGHWAY SUITE 100
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City | COLLEGE PARK
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State | GA
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Zip | 30349
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Country | US
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Telephone | 470-765-8550
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Fax |
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Provider Business Mailing Address
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Address Line | 100 POSTMASTER DR UNIT 2282
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City | MCDONOUGH
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State | GA
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Zip | 30253-9998
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Country | US
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Telephone | 470-765-8550
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAILT THERAPIST
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Name | MRS. BRIDGETTE REED
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Credential | LMFT
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Telephone | 470-765-8550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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