Doctor Name: | DR. BRIDGET ANNE RUSSELL |
NPI Number: | 1992843320 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD CCC-SLP |
License Number: | 008132-00 |
Business Practice Address: | W132 Thompson Hall Suny Fredonia Fredonia, NY - 14063 |
Business Phone Number: | 7166734616 |
Business Fax Number: | 7166733235 |
Mailing Address: | 103 Newton St, FREDONIA |
State: | NY |
Postal Code: | 140631303 |
Phone Number: | 7166734616 |
Fax Number: | 7166733235 |
NPI Enumeration Date: | 02/01/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 008132-00 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
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 |