Provider Demographics
NPI:1740760396
Name:WORK, BRIDGETTE LEANNE
Entity Type:Individual
Prefix:MRS
First Name:BRIDGETTE
Middle Name:LEANNE
Last Name:WORK
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:BRIDGETTE
Other - Middle Name:LEANNE
Other - Last Name:FLETCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 NW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-3424
Mailing Address - Country:US
Mailing Address - Phone:501-847-5660
Mailing Address - Fax:501-847-5662
Practice Address - Street 1:200 NW 4TH ST
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-3424
Practice Address - Country:US
Practice Address - Phone:501-847-5660
Practice Address - Fax:501-847-5662
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1996235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist