Provider Demographics
NPI:1982321345
Name:BARRETT, BRIDGET ANN (SLP)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:ANN
Last Name:BARRETT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:ANN
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1463 OAK SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-3971
Mailing Address - Country:US
Mailing Address - Phone:217-502-2028
Mailing Address - Fax:
Practice Address - Street 1:1700 MULKEY RD
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1116
Practice Address - Country:US
Practice Address - Phone:770-941-5750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP011492235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist