Provider Demographics
NPI:1902389224
Name:BIGGERS, BONNIE CAROLYN (MCD, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:CAROLYN
Last Name:BIGGERS
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:658 JOHN WESLEY DOBBS AVE NE APT 5
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1666
Mailing Address - Country:US
Mailing Address - Phone:850-499-5037
Mailing Address - Fax:
Practice Address - Street 1:658 JOHN WESLEY DOBBS AVE NE APT 5
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1666
Practice Address - Country:US
Practice Address - Phone:850-499-5037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP010151235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist