Individual
BRIDGETTE BOBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11520 SAINT CHARLES ROCK RD STE 103, BRIDGETON, MO 63044-2732
(314) 418-9689
Mailing address
PO BOX 15004, SAINT LOUIS, MO 63110-0004
(314) 418-9689
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2019039826
MO
Other
Enumeration date
11/02/2019
Last updated
12/03/2019
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