Individual
MRS. BRIDGETTE DENISE MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
312 SW GREENWICH DR STE 733, LEES SUMMIT, MO 64082-4408
(913) 712-0565
(816) 537-8605
Mailing address
6216 SWOPE PKWY, KANSAS CITY, MO 64130-4447
(913) 687-8795
(816) 537-8605
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2001031951
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
499012508
—
MO
Enumeration date
06/11/2007
Last updated
01/22/2022
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