Individual
BRIDGET O. HANNAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
3168 MIDTOWN PARK S STE E, MOBILE, AL 36606-4123
(251) 421-4313
Mailing address
PO BOX 1768, POINT CLEAR, AL 36564-1768
(251) 421-4313
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
774
AL
103TC2200X
Clinical Child & Adolescent Psychologist
774
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09070760
—
MS
01
—
51539165
BLUE CROSS BLUE SHIELD
AL
05
—
890019220
—
AL
Enumeration date
11/27/2006
Last updated
02/26/2021
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