Provider Demographics
NPI:1609332329
Name:DEAN, BRIDGET HALEY (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:HALEY
Last Name:DEAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 KOSTER DR
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2835
Mailing Address - Country:US
Mailing Address - Phone:732-241-5848
Mailing Address - Fax:
Practice Address - Street 1:171 KOSTER DR
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2835
Practice Address - Country:US
Practice Address - Phone:732-241-5848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-18
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJYS00412600235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty