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Organization
BRIDGEWAY COUNSELING LLC
Active
Organization
BRIDGEWAY COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDIFATAH ISSE NUUH MAHHSA/ALD (OWNER/MANAGER)
(612) 242-0673
Entity
Organization
Contact information
Practice address
4204 16TH AVE S, MINNEAPOLIS, MN 55407-3312
(612) 242-0673
Mailing address
4204 16TH AVE S, MINNEAPOLIS, MN 55407-3312
(612) 242-0673
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
—
—
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
12/27/2020
Last updated
06/12/2023
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