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NPI Code Detail

MEDICARE: MS. BRIDGET L BROWN M.A.,L.M.F.T.

MEDICARE: MS. BRIDGET L BROWN M.A.,L.M.F.T.
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
1106H00000XMarriage & Family Therapist747MN

General Provider Information

NPI Number : 1740496769
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BRIDGET L BROWN M.A.,L.M.F.T.
Provider Business Mailing Address
First Line : 720 5TH ST N
Second Line :
City : STILLWATER
State : MN
Zip : 55082-4407
Country : US
Telephone Number : 651-351-0829
Fax Number :
Provider Business Practice Location Address
First Line : 14955 GALAXIE AVE
Second Line :
City : APPLE VALLEY
State : MN
Zip : 55124-4519
Country : US
Telephone Number : 952-891-7156
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2007
Last Update Date : 07/08/2007

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