Provider Demographics
NPI:1033355391
Name:STUDER, BRIDGET MARIE (MS, CCC)
Entity Type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:MARIE
Last Name:STUDER
Suffix:
Gender:F
Credentials:MS, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 153837
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75915-3837
Mailing Address - Country:US
Mailing Address - Phone:936-639-2693
Mailing Address - Fax:936-634-9791
Practice Address - Street 1:714 LARGENT ST
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3232
Practice Address - Country:US
Practice Address - Phone:936-639-2693
Practice Address - Fax:936-634-9791
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10586235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist