Individual
LEDETRA BRIDGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3400 LEBANON RD, MURFREESBORO, TN 37129-1392
(615) 525-4793
Mailing address
3400 LEBANON RD, MURFREESBORO, TN 37129-1392
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2023
MS
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
C8677
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020986
—
AK
Enumeration date
03/02/2012
Last updated
04/19/2024
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