Provider Demographics
NPI:1205955192
Name:WOOD, BRIDGET KATHLEEN (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:KATHLEEN
Last Name:WOOD
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MS
Other - First Name:BRIDGET
Other - Middle Name:K
Other - Last Name:HARRIGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9358 S BELL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-6711
Mailing Address - Country:US
Mailing Address - Phone:773-412-2445
Mailing Address - Fax:312-842-1215
Practice Address - Street 1:9358 S BELL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-6711
Practice Address - Country:US
Practice Address - Phone:773-412-2445
Practice Address - Fax:312-842-1215
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146007986235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist