| NPI | 1699031112 |
|---|---|
| Former Name | STEPHANIE ELLEN BRIDGEMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146010926) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 105353) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2012-04-10 |