Individual
MARY J. BRIDLE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MA, OTL
Contact information
Practice address
696 BERKMAR CIR, CHARLOTTESVILLE, VA 22901-1464
(434) 817-4100
(434) 817-4101
Mailing address
696 BERKMAR CIR, CHARLOTTESVILLE, VA 22901-1464
(434) 817-4100
(434) 817-4101
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119000064
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104332
ANTHEM
VA
Enumeration date
03/31/2006
Last updated
07/08/2007
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