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NPI Code Detail

MEDICARE: TERESA BRIDGES SLP-CCC

MEDICARE: TERESA BRIDGES SLP-CCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist1084TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11084OTHERTNTN HEALTH LICENSE

General Provider Information

NPI Number : 1811544364
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA BRIDGES SLP-CCC
Provider Business Mailing Address
First Line : PO BOX 8114
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37414-0114
Country : US
Telephone Number : 423-622-1551
Fax Number : 877-856-7133
Provider Business Practice Location Address
First Line : 800 S LEE HWY
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-5853
Country : US
Telephone Number : 423-622-1551
Fax Number : 877-856-7133
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2019
Last Update Date : 08/20/2019

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Directions to “ TERESA BRIDGES SLP-CCC” Practice Location

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