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Individual

MRS. PEGGY LYNN BRIDGES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BS, CRADC

Contact information

Practice address
1109 JONES ST, KENNETT, MO 63857-3824
(573) 888-6545
(573) 888-2369
Mailing address
1109 JONES ST, PO BOX 470, KENNETT, MO 63857-3824
(573) 888-6545
(573) 888-2369

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2938
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
162252
BLUE CHOICE
MO
01
507496
HEALTHLINK PPO
MO
Enumeration date
06/01/2007
Last updated
03/05/2013
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