Individual
BRIDGET BROWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3568 GERAGHTY AVE, FAIRBANKS, AK 99709-4701
(907) 374-7001
Mailing address
3568 GERAGHTY AVE, FAIRBANKS, AK 99709-4701
(907) 374-7001
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020986
—
AK
Enumeration date
03/16/2018
Last updated
12/12/2019
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