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General NPI Number Information
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NPI Number | 1457866303
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Entity Type | Individual
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Provider Name | MICHAELA BEDRIN CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 12/13/2017
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 751 W HILL RD
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City | STAMFORD
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State | CT
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Zip | 06902-1413
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Country | US
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Telephone | 203-977-4287
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Fax |
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Provider Business Mailing Address
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Address Line | 18 LEDGEWOOD DR
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City | NORWALK
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State | CT
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Zip | 06850-1823
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Country | US
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Telephone | 209-598-0396
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 005381
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License Number State | CT
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