Provider Demographics
NPI:1922283829
Name:BRICKER, KATHY K (AUD)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:K
Last Name:BRICKER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7250 COLLEGE PKWY
Mailing Address - Street 2:SUITE 7
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-5606
Mailing Address - Country:US
Mailing Address - Phone:239-771-6003
Mailing Address - Fax:239-939-0250
Practice Address - Street 1:7250 COLLEGE PARKWAY
Practice Address - Street 2:SUITE 7
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907
Practice Address - Country:US
Practice Address - Phone:239-771-6003
Practice Address - Fax:239-939-0250
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1105231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist