Provider Demographics
NPI:1154822914
Name:BIDWELL, ASHTYN (MA ED, CF-SLP)
Entity Type:Individual
Prefix:
First Name:ASHTYN
Middle Name:
Last Name:BIDWELL
Suffix:
Gender:F
Credentials:MA ED, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SHEFFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40391-8558
Mailing Address - Country:US
Mailing Address - Phone:606-362-8603
Mailing Address - Fax:
Practice Address - Street 1:101 SHEFFIELD WAY
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-8558
Practice Address - Country:US
Practice Address - Phone:606-362-8603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY174180235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist