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Individual

JOHN RUSSELL BRIDGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D., M.S.

Contact information

Practice address
1016 W UNIVERSITY AVE STE 202, FLAGSTAFF, AZ 86001-2996
(970) 844-7151
Mailing address
1016 W UNIVERSITY AVE STE 202, FLAGSTAFF, AZ 86001-2996
(970) 844-7151

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
103TC0700X
Clinical Psychologist
Primary
PSY-005572
AZ
103TC0700X
Clinical Psychologist
PSY.0005360
CO

Other

Enumeration date
04/08/2016
Last updated
08/17/2023
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