Individual
JESSICA LYNN BRIDGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
25 WOODS LAKE RD, SUITE 412, GREENVILLE, SC 29607-6125
(864) 219-8907
Mailing address
19 SHADOWROCK CT, SIMPSONVILLE, SC 29681-5177
(864) 219-8907
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5197
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PC1085
—
SC
Enumeration date
09/08/2010
Last updated
01/04/2017
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