Individual
GORDANA BRIDGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
705 BELAUTO CT, BEAVERCREEK, OH 45430-1778
(937) 416-8902
Mailing address
705 BELAUTO CT, BEAVERCREEK, OH 45430-1778
(937) 416-8902
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
176080
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
176080
CDCA
OH
Enumeration date
07/13/2021
Last updated
07/13/2021
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