Individual
BRIDGETTE HENNESSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
61453426
WA
225700000X
Massage Therapist
MA00023680
WA
Other
Enumeration date
08/28/2014
Last updated
01/26/2024
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