Individual
TYKIA D BRIDDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
180 CENTRE ST, BROCKTON, MA 02302-2733
(508) 586-6300
Mailing address
180 CENTRE ST, BROCKTON, MA 02302-2733
(508) 586-6300
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
101YA0400X
MA
Other
Enumeration date
08/09/2024
Last updated
08/09/2024
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