| Bridgeway Agency, Llc | |
|
4511 Ne County Road 219a Melrose FL 32666-6027 | |
| (352) 727-9304 | |
| Not Available |
| Full Name | Bridgeway Agency, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 4511 Ne County Road 219a, Melrose, Florida |
| Authorized Official Name and Position | Kassandra Bryan (OWNER/BCBA) |
| Authorized Official Contact | 3527279304 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridgeway Agency, Llc 4511 Ne County Road 219a Melrose FL 32666-6027 Ph: (352) 727-9304 | Bridgeway Agency, Llc 4511 Ne County Road 219a Melrose FL 32666-6027 Ph: (352) 727-9304 |
| NPI Number | 1962156281 |
|---|---|
| Provider Enumeration Date | 02/06/2022 |
| Last Update Date | 05/26/2022 |
| Certification Date | 05/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962156281 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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