Individual
CHRISTINA MARIE BRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
4101 S 4TH ST, LEAVENWORTH, KS 66048-5014
(913) 682-2000
Mailing address
4101 S 4TH ST, LEAVENWORTH, KS 66048-5014
(913) 682-2000
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4200
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100098080A
—
KS
Enumeration date
02/13/2007
Last updated
08/18/2014
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