Doctor Name: | MS. KAREN MARIE BRIDWELL |
NPI Number: | 1407043771 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.C.P.C |
License Number: | 180007734 |
Business Practice Address: | 461 Briargate Dr South Elgin, IL - 601772225 |
Business Phone Number: | 2245785548 |
Business Fax Number: | |
Mailing Address: | 835 Gregory Ln, SCHAUMBURG |
State: | IL |
Postal Code: | 601933916 |
Phone Number: | 2245785548 |
Fax Number: | |
NPI Enumeration Date: | 10/01/2007 |
NPI Last Update Date: | 03/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 180007734 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |