Provider Demographics
NPI:1174359442
Name:BRIDGES, ISABELLA LAINE
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:LAINE
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9701 DORTMUND DR SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35803-1115
Mailing Address - Country:US
Mailing Address - Phone:256-808-4146
Mailing Address - Fax:
Practice Address - Street 1:9701 DORTMUND DR SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35803-1115
Practice Address - Country:US
Practice Address - Phone:256-808-4146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker