Provider Information for 1083873012
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BRIDGETTE JEAN FIELDER LPC
Sex: Female
NPI: 1083873012
Last Updated: 2024-10-29
Certification Date: 2024-10-24
Certification Date: 2024-10-24
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1083873012 | ||||||||||||
| Enumeration Date | 2008-06-05 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1815 PLEASANT GROVE ROAD JONESBORO, AR 72405-7870 United States Phone: 870-933-6886 | Fax:870-933-9395 | ||||||||||||
| Primary Practice Address | 3201 W. KEISER OSCEOLA, AR 72370-3467 United States Phone: 870-622-0592 | Fax:870-622-0782 | ||||||||||||
| Secondary Practice Address(es) | 46 E STATE HWY 162 | ||||||||||||
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