Provider Demographics
NPI:1801547922
Name:REED, BRIDGETTE
Entity type:Individual
Prefix:MRS
First Name:BRIDGETTE
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRIDGETTE
Other - Middle Name:
Other - Last Name:RIGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:100 POSTMASTER DR UNIT 2282
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-9998
Mailing Address - Country:US
Mailing Address - Phone:470-765-8550
Mailing Address - Fax:
Practice Address - Street 1:5534 OLD NATIONAL HIGHWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30349
Practice Address - Country:US
Practice Address - Phone:470-765-8550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-11
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT001929106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA