Aja Bridgewater, LCSW
Social Worker, Clinical in Indianapolis, IN. Individual provider (NPI-1).
NPI number1457769986
StatusActive
Last updated in NPPESOct 6, 2020
Details
- NPI
- 1457769986
- Entity type
- Individual (NPI-1)
- Name
- Aja Bridgewater
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 29, 2014
- Certification date
- Oct 6, 2020
- Last updated
- Oct 6, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 34006864A | IN | Yes |
Other names
- Aja Boudreau (Former Name)
Practice location
8320 Madison AveIndianapolis, IN 46227-6066
Phone 317-882-5122 · Fax 317-888-8642
Mailing address
8320 Madison AveIndianapolis, IN 46227-6066
Phone 317-882-5122 · Fax 317-888-8642
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