Provider Demographics
NPI:1497626329
Name:WOLSONOVICH, BRIDGET MARY
Entity type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:MARY
Last Name:WOLSONOVICH
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 1:48193 METZ RD
Mailing Address - Street 2:
Mailing Address - City:NEW WATERFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44445-9779
Mailing Address - Country:US
Mailing Address - Phone:740-821-1366
Mailing Address - Fax:
Practice Address - Street 1:48193 METZ RD
Practice Address - Street 2:
Practice Address - City:NEW WATERFORD
Practice Address - State:OH
Practice Address - Zip Code:44445-9779
Practice Address - Country:US
Practice Address - Phone:740-821-1366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator