Provider Demographics
NPI:1316265119
Name:BRIDGES, SONIA MONIQUE
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:MONIQUE
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4075 PARK FULTON OVAL APT 821
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44144-1835
Mailing Address - Country:US
Mailing Address - Phone:440-798-3913
Mailing Address - Fax:
Practice Address - Street 1:4075 PARK FULTON OVAL APT 821
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44144-1835
Practice Address - Country:US
Practice Address - Phone:440-798-3913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400574250107376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide