Provider Demographics
NPI:1821326141
Name:CROUCH, BRIDGET ANNE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:ANNE
Last Name:CROUCH
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:505 E MATTHEWS AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-3144
Mailing Address - Country:US
Mailing Address - Phone:870-972-5224
Mailing Address - Fax:870-972-1417
Practice Address - Street 1:505 E MATTHEWS AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-3144
Practice Address - Country:US
Practice Address - Phone:870-972-5224
Practice Address - Fax:870-972-1417
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#2807235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist