Individual
DR. BRIDGET MARY HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, HSPP, BCBA
Contact information
Practice address
8200 GEORGIA ST, MERRILLVILLE, IN 46410-6227
(219) 791-1400
(219) 791-1422
Mailing address
8200 GEORGIA ST, MERRILLVILLE, IN 46410-6227
(219) 791-1400
(219) 791-1422
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-08-4182
IN
103T00000X
Psychologist
Primary
20041444A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000392067
ANTHEM BC/BS
IN
01
—
11379616
CAQH
IN
05
—
200429240
—
IN
05
—
200462360
—
IN
01
—
793670000
MAGELLAN
IN
Enumeration date
08/31/2006
Last updated
01/30/2023
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