Individual
BRIDGET ANN BARDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
13766 FORT ST, SOUTHGATE, MI 48195-1153
(734) 282-3717
Mailing address
25773 BRISTOL DR, FLAT ROCK, MI 48134-1815
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7501000504
MASSAGE THERAPIST LICENSE
MI
05
—
76629309
—
MI
Enumeration date
01/07/2018
Last updated
01/11/2018
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