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Organization

BRIDGEWAY CHRISTIAN CHURCH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID HEITZLER LMFT (SOUL CARE DIRECTOR)
(916) 625-6010
Entity
Organization

Contact information

Practice address
8150 INDUSTRIAL AVE BLDG A, ROSEVILLE, CA 95678-5903
(916) 626-3017
Mailing address
8150 INDUSTRIAL AVE BLDG A, ROSEVILLE, CA 95678-5903

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
09/04/2024
Last updated
09/04/2024
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