Provider Demographics
NPI:1679314652
Name:JOHNSON, BRIDGET (MS, CFY-SLP)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MS, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 AVENUE E STE A
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-2943
Mailing Address - Country:US
Mailing Address - Phone:406-690-6996
Mailing Address - Fax:406-206-5262
Practice Address - Street 1:1701 AVENUE E STE A
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-2943
Practice Address - Country:US
Practice Address - Phone:406-690-6996
Practice Address - Fax:406-206-5262
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist