Provider Demographics
NPI:1033411103
Name:BEDALOV, PATRICIA MARY (SPEECH-LANGUAGE PATH)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:MARY
Last Name:BEDALOV
Suffix:
Gender:F
Credentials:SPEECH-LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 W. 26TH AVE.
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203
Mailing Address - Country:US
Mailing Address - Phone:509-624-4750
Mailing Address - Fax:
Practice Address - Street 1:1017 W. 26TH AVE.
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203
Practice Address - Country:US
Practice Address - Phone:509-624-4750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00002007235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist