Provider Demographics
NPI:1932917184
Name:ALEXANDER, BRIDGET MICHELLE (PLPC)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:MICHELLE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 RUE DU BELIER APT 710
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-6553
Mailing Address - Country:US
Mailing Address - Phone:337-717-9697
Mailing Address - Fax:
Practice Address - Street 1:850 KALISTE SALOOM RD STE 212
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-4230
Practice Address - Country:US
Practice Address - Phone:337-504-4974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9747101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health