Organization
BRIDGE BUILDERS PASTORAL COUNSELING AND PSYCHOTHERAPY
Active
Organization
BRIDGE BUILDERS PASTORAL COUNSELING AND PSYCHOTHERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS M OWEN LPC (PRESIDENT)
(910) 792-9888
Entity
Organization
Contact information
Practice address
5919 OLEANDER DR, SUITE 104, WILMINGTON, NC 28403-4780
(910) 792-9888
(910) 792-9883
Mailing address
5919 OLEANDER DR, SUITE 104, WILMINGTON, NC 28403-4780
(910) 792-9888
(910) 792-9883
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6006898
—
NC
Enumeration date
05/19/2006
Last updated
06/19/2012
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