Individual
BRIDGETTE A. STOVALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4119 LEAVITT RD, LORAIN, OH 44053-2341
(440) 282-3127
Mailing address
4119 LEAVITT RD, LORAIN, OH 44053-2341
(440) 282-3127
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164811725
—
OH
Enumeration date
10/08/2025
Last updated
10/08/2025
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