Organization
KONI B. BRIDGES, LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KONI B. BRIDGES LCSW (OWNER)
(337) 625-5664
Entity
Organization
Contact information
Practice address
1918 MAPLEWOOD DR, SULPHUR, LA 70663-6006
(337) 625-5664
(337) 625-5660
Mailing address
1918 MAPLEWOOD DR, SULPHUR, LA 70663-6006
(337) 625-5664
(337) 625-5660
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2739
LA
Other
Enumeration date
03/15/2011
Last updated
03/15/2011
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