Provider Demographics
NPI:1710377163
Name:BICKFORD, VERNENNA DONNA (MA, CCC-S)
Entity Type:Individual
Prefix:
First Name:VERNENNA
Middle Name:DONNA
Last Name:BICKFORD
Suffix:
Gender:F
Credentials:MA, CCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 2 BOX 741
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:WV
Mailing Address - Zip Code:25541-9506
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 S. 4TH STREET
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-9506
Practice Address - Country:US
Practice Address - Phone:740-532-4223
Practice Address - Fax:740-532-7226
Is Sole Proprietor?:No
Enumeration Date:2015-01-23
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-7254235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist