National Provider Identifier

Bridget Anne Russell, PHD CCC-SLP

Bridget Anne Russell, PHD CCC-SLP is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Fredonia, NY and a listed phone number of (716) 673-4616.

NPI 1992843320Fredonia, NYSpeech-Language Pathologist

Profile Overview

NPI
1992843320
Provider Type
Individual
Primary Specialty
Speech-Language Pathologist
Enumeration Date
February 01, 2007
Last Updated
July 08, 2007

Practice Location

  • W132 Thompson Hall
  • Suny Fredonia
  • Fredonia, NY 14063

Phone: (716) 673-4616

Mailing Address

  • 103 Newton St
  • Fredonia, NY 14063-1303

Specialties

  • Speech-Language Pathologist (235Z00000X)
Full Record
NPI
1992843320
Entity Type
Individual
Last Name
Russell
First Name
Bridget
Middle Name
Anne
Name Prefix
Dr.
Credential
PHD CCC-SLP
Mailing Street Address
103 Newton St
Mailing City
Fredonia
Mailing State
NY
Mailing ZIP Code
14063-1303
Mailing Country
US
Mailing Phone
(716) 673-4616
Mailing Fax
(716) 673-3235
Practice Street Address
W132 Thompson Hall
Practice Address Line 2
Suny Fredonia
Practice City
Fredonia
Practice State
NY
Practice ZIP Code
14063
Practice Country
US
Practice Phone
(716) 673-4616
Practice Fax
(716) 673-3235
Enumeration Date
February 01, 2007
Last Updated
July 08, 2007
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Speech-Language Pathologist (235Z00000X)