Individual
LISA BRIDGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
1909 CHEKER SQ, EAST HAZEL CREST, IL 60429-1442
(708) 647-3321
Mailing address
1909 CHEKER SQ, EAST HAZEL CREST, IL 60429-1442
(708) 647-3321
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1995
GOVERNORS STATE UNIVERSITY
IL
Enumeration date
04/21/2016
Last updated
04/21/2016
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