Provider Demographics
NPI:1780144931
Name:KARGBO-HILL, BRIDGET VICTORIA
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:VICTORIA
Last Name:KARGBO-HILL
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 1:5801 JACKSONS OAK CT
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-2304
Mailing Address - Country:US
Mailing Address - Phone:703-539-9626
Mailing Address - Fax:
Practice Address - Street 1:49 QUINCY CT
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-5755
Practice Address - Country:US
Practice Address - Phone:908-268-9437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-23
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VARBT-17-43329106E00000X
1-22-59118103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst