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NPI Code Detail

MEDICARE: MS. CARMEN RAQUEL BRIDGES B.A.

MEDICARE: MS. CARMEN RAQUEL BRIDGES B.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063786218
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CARMEN RAQUEL BRIDGES B.A.
Provider Business Mailing Address
First Line : 6148 W SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-3052
Country : US
Telephone Number : 702-749-9800
Fax Number : 702-749-9801
Provider Business Practice Location Address
First Line : 6148 W SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-3052
Country : US
Telephone Number : 702-749-9800
Fax Number : 702-749-9801
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2012
Last Update Date : 03/06/2012

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Directions to “ MS. CARMEN RAQUEL BRIDGES B.A.” Practice Location

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