Organization
BRIDGEWAY THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LASHAWN THOMAS BRIDGES SLPD (OWNER)
(803) 400-3829
Entity
Organization
Contact information
Practice address
10120 TWO NOTCH RD, COLUMBIA, SC 29223-4395
(803) 400-3829
Mailing address
10120 TWO NOTCH RD, COLUMBIA, SC 29223-4395
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891771796
NPI
SC
Enumeration date
11/23/2022
Last updated
11/23/2022
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