Provider Demographics
NPI:1174980841
Name:BECHARD, BRIDGET
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:BECHARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 HICKORY ST
Mailing Address - Street 2:PO BOX 101
Mailing Address - City:WAKEFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67487-9109
Mailing Address - Country:US
Mailing Address - Phone:785-307-2762
Mailing Address - Fax:
Practice Address - Street 1:2025 LITTLE KITTEN AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66503-7545
Practice Address - Country:US
Practice Address - Phone:785-776-0065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18-00788224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant