Provider Demographics
NPI:1104019306
Name:BIDNEY, ANDREA JANETTE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:JANETTE
Last Name:BIDNEY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-7534
Mailing Address - Country:US
Mailing Address - Phone:251-626-3026
Mailing Address - Fax:
Practice Address - Street 1:3717 DAUPHIN ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1777
Practice Address - Country:US
Practice Address - Phone:251-343-0909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2232235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist