Individual
DR. PATRICIA E BRIDGEWATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1819 WEST AUSTIN, SUITE C, NEVADA, MO 64772-2202
(417) 283-6151
(417) 283-6152
Mailing address
1819 W AUSTIN BLVD STE C, PO BOX 177, NEVADA, MO 64772-3708
(417) 283-6151
(417) 283-6152
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1999140492
MO
103TC0700X
Clinical Psychologist
6301011168
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
494768302
—
MO
Enumeration date
10/26/2006
Last updated
02/24/2014
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