Individual
MRS. BRIDGETTE JASPER WALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2312 DURWOOD RD, LITTLE ROCK, AR 72207-3431
(501) 313-5973
Mailing address
2312 DURWOOD RD, LITTLE ROCK, AR 72207-3431
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-62850
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
902566664
SPECIALTY
AR
Enumeration date
12/20/2018
Last updated
12/20/2018
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