Organization
BRIDGESTONE MENTAL WELLNESS & THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIDGET FAMOGUN (PROVIDER)
(240) 441-1888
Entity
Organization
Contact information
Practice address
43736 TOLAMAC DR, ASHBURN, VA 20147-4761
(240) 441-1888
Mailing address
43736 TOLAMAC DR, ASHBURN, VA 20147-4761
(240) 441-1888
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/01/2024
Last updated
02/01/2024
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