Provider Demographics
NPI:1649501925
Name:BRIDGES-LOCKETT, JOYCE L (OTR)
Entity type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:L
Last Name:BRIDGES-LOCKETT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5010 ELIZABETH RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-4537
Mailing Address - Country:US
Mailing Address - Phone:704-564-5973
Mailing Address - Fax:
Practice Address - Street 1:5010 ELIZABETH RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-4537
Practice Address - Country:US
Practice Address - Phone:704-564-5973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-26
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6194225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist