Individual
DR. MICHAEL J. BRIDGEWATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
7272 WURZBACH RD STE 706, SAN ANTONIO, TX 78240-4803
(210) 615-3483
Mailing address
3717 WREN AVE, FORT WORTH, TX 76133-2909
(817) 875-0770
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
22002
TX
103TB0200X
Cognitive & Behavioral Psychologist
22002
TX
103TC0700X
Clinical Psychologist
Primary
30028
TX
103TF0000X
Family Psychologist
22002
TX
103TS0200X
School Psychologist
22002
TX
Other
Enumeration date
05/22/2007
Last updated
06/17/2021
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