Provider Demographics
NPI:1962633420
Name:BRIDGES, LATONIA VANESS (CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:LATONIA
Middle Name:VANESS
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3761 RED CEDAR DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-5064
Mailing Address - Country:US
Mailing Address - Phone:719-219-6720
Mailing Address - Fax:719-302-1712
Practice Address - Street 1:3761 RED CEDAR DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-5064
Practice Address - Country:US
Practice Address - Phone:719-219-6720
Practice Address - Fax:719-302-1712
Is Sole Proprietor?:No
Enumeration Date:2009-08-01
Last Update Date:2009-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist