Provider Demographics
NPI:1063932721
Name:SPEISER, BRIDGET (CPRP)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:SPEISER
Suffix:
Gender:F
Credentials:CPRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11205 LILAC LN
Mailing Address - Street 2:
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-9760
Mailing Address - Country:US
Mailing Address - Phone:443-722-0980
Mailing Address - Fax:443-200-1400
Practice Address - Street 1:11205 LILAC LN
Practice Address - Street 2:
Practice Address - City:PERRY HALL
Practice Address - State:MD
Practice Address - Zip Code:21128-9760
Practice Address - Country:US
Practice Address - Phone:443-722-0980
Practice Address - Fax:443-200-1400
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor