Provider Demographics
NPI:1235513300
Name:BERRIDGE, CAROLYN ANN (AUD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:ANN
Last Name:BERRIDGE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 VARDEN DR STE A
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-5202
Mailing Address - Country:US
Mailing Address - Phone:803-641-6104
Mailing Address - Fax:
Practice Address - Street 1:39 VARDEN DR
Practice Address - Street 2:SUITE A
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-5202
Practice Address - Country:US
Practice Address - Phone:803-641-6104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2022-07-11
Deactivation Date:2020-06-08
Deactivation Code:
Reactivation Date:2022-07-11
Provider Licenses
StateLicense IDTaxonomies
SC4030231H00000X
GAAUD004008231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist