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Individual

BRIDGET LOUISE MIXON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
22776 THREE NOTCH RD STE 102, LEXINGTON PARK, MD 20653-3369
(301) 880-4833
(301) 760-3472
Mailing address
11725 LONG SHADOW LN, LUSBY, MD 20657-2421
(410) 960-2781

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
18001
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18001
BOARD OF SOCIAL WORK EXAMINERS
MD
Enumeration date
09/08/2018
Last updated
09/08/2018
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