Individual
MS. CORETTA DIANE BRIDGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
13305 REECK CT, SOUTHGATE, MI 48195-3197
(734) 225-2090
(734) 225-2091
Mailing address
6549 TOWN CENTER DR STE A, CLARKSTON, MI 48346-4824
(248) 620-6400
(248) 620-6405
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801066664
MI
Other
Enumeration date
06/30/2016
Last updated
06/19/2019
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