Provider Demographics
NPI:1578876967
Name:POWERS, BRIDGET (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:BRIDGET
Middle Name:
Last Name:POWERS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:BRIDGET
Other - Middle Name:
Other - Last Name:UNTERSEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:39 CLAY BROOK DR.
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03264
Mailing Address - Country:US
Mailing Address - Phone:603-726-1979
Mailing Address - Fax:603-536-9757
Practice Address - Street 1:39 CLAY BROOK DR.
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264
Practice Address - Country:US
Practice Address - Phone:603-726-1979
Practice Address - Fax:603-536-9757
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0575235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist