Provider Demographics
NPI:1346557295
Name:CONTRERAS, BRIDGET DEHANTSETTERS (SLP)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:DEHANTSETTERS
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:DEHANTSETTERS
Other - Last Name:SMYTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1619 COUNTRY LAKES DR
Mailing Address - Street 2:#103
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-9044
Mailing Address - Country:US
Mailing Address - Phone:407-616-2654
Mailing Address - Fax:
Practice Address - Street 1:1245 CORPORATE BLVD
Practice Address - Street 2:STE 101
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-7607
Practice Address - Country:US
Practice Address - Phone:630-898-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA7423235Z00000X
IL146010184235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist