Ann Brideweser

Individual provider Active NPI Speech-Language Pathologist · Bolivar, OH

NPI 1306242987 · NPPES record last updated Nov 10, 2014

Key facts

NPI
1306242987
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
5210 (OH)
Practice address
216 Park Ave NW
Bolivar, OH 44612-9504
Phone
(330) 874-3234
NPI assigned
Nov 10, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5210OHMDChiropractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 5210 OH Yes

Addresses

Primary practice location

216 Park Ave NW
Bolivar, OH 44612-9504

Mailing address

216 Park Ave NW
Bolivar, OH 44612-9504
Phone (330) 874-3234

Other providers in Bolivar, OH

All providers in Bolivar, OH · Speech-Language Pathologist in Ohio

Sources for this page

Verify at the official NPI Registry.