Provider Demographics
NPI:1194094599
Name:CORBET, BRIDGET (MA, BCBA)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:CORBET
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 NIAGARA ST
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-1458
Mailing Address - Country:US
Mailing Address - Phone:630-247-6907
Mailing Address - Fax:
Practice Address - Street 1:811 NIAGARA ST
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-1458
Practice Address - Country:US
Practice Address - Phone:630-247-6907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst