Organization
BRIDGE CONSULTING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATONYA WHITAKER (MANAGER/THERAPIST)
(623) 850-8764
Entity
Organization
Contact information
Practice address
4150 W NORTHERN AVE STE 160, 4140 W NORTHERN AVE SUITE 3, PHOENIX, AZ 85051-5785
(623) 850-8764
Mailing address
4140 W NORTHERN AVE STE 3, PHOENIX, AZ 85051-5793
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11290
AZ
Other
Enumeration date
09/26/2013
Last updated
01/16/2014
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