Individual
REBECCA BRIDGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
301 FORT LN, PORTSMOUTH, VA 23704-2221
(757) 391-6763
Mailing address
4101 KALONA RD, PORTSMOUTH, VA 23703-2065
(757) 334-1984
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/27/2013
Last updated
08/27/2013
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