Provider Demographics
NPI:1649436197
Name:GARRIDO, BRIDGET BETTY (AUD)
Entity type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:BETTY
Last Name:GARRIDO
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 1:555 DR MICHAEL DEBAKEY DR
Mailing Address - Street 2:STE 104
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-5700
Mailing Address - Country:US
Mailing Address - Phone:337-436-3277
Mailing Address - Fax:
Practice Address - Street 1:555 DOCTOR MICHAEL DEBAKEY DR STE 104
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-5700
Practice Address - Country:US
Practice Address - Phone:337-436-3277
Practice Address - Fax:337-439-3051
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3317231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2432346Medicaid