| Doctor Name: | MRS. BRIDGETTE BLACKBURN |
| NPI Number: | 1225361611 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | KY-2897 |
| Business Practice Address: | 113 Maloney Way Mt Sterling, KY - 403539553 |
| Business Phone Number: | 8594980011 |
| Business Fax Number: | 8594985001 |
| Mailing Address: | 113 Maloney Way, MT STERLING |
| State: | KY |
| Postal Code: | 403539553 |
| Phone Number: | 8594980011 |
| Fax Number: | 8594985001 |
| NPI Enumeration Date: | 09/16/2009 |
| NPI Last Update Date: | 09/16/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | KY-2897 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |