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General NPI Number Information
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NPI Number | 1922406586
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Entity Type | Individual
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Provider Name | BRIDGET AMBER GODSON M.S. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 12/15/2014
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 529 WESTPORT RD
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-2923
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Country | US
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Telephone | 270-807-0316
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Fax |
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Provider Business Mailing Address
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Address Line | 363 W LINCOLN TRAIL BLVD
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City | RADCLIFF
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State | KY
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Zip | 40160-3302
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Country | US
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Telephone | 502-780-9137
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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 | 276509
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 110889
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 4683
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License Number State | KS
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