Individual
BRIDGET AGYEI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1235 W CASTLE DR, CASA GRANDE, AZ 85122-6652
(520) 334-9351
Mailing address
1235 W CASTLE DR, CASA GRANDE, AZ 85122-6652
(520) 334-9351
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
BH4047
AZ
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/20/2022
Last updated
01/12/2023
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