Provider Information for 1891925855
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BRIDGETTE L TERRAZAS LCSW
Other Names:Former Name:BRIDGETTE L JACQUEZ LCSWSex: Female
NPI: 1891925855
Last Updated: 2016-06-14
Certification Date:
Certification Date:
Details
Name | Value | ||||||||||||
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NPI | 1891925855 | ||||||||||||
Enumeration Date | 2009-07-23 | ||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||
Sole Proprietor | NO | ||||||||||||
Status | Active | ||||||||||||
Mailing Address | 9520 W PALM LN SUITE 200 PHOENIX, AZ 85037-4403 United States Phone: 623-583-3001 | Fax:623-583-3007 | ||||||||||||
Primary Practice Address | 1705 W MAIN ST MESA, AZ 85201-6920 United States Phone: 877-809-5092 | Fax: | ||||||||||||
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