Individual
MISS BRIDGET ANNE DEDELOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1705 CENTENNIAL BLVD STE 2, SPRINGFIELD, OR 97477-3320
(541) 818-0009
Mailing address
324 GOLFVIEW DR, SCHERERVILLE, IN 46375-2042
(219) 323-9052
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
OR
Other
Enumeration date
08/17/2021
Last updated
07/27/2022
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