Provider Demographics
NPI:1225901135
Name:CHOQUETTE, BRISTOL LOWDER (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:BRISTOL
Middle Name:LOWDER
Last Name:CHOQUETTE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MS
Other - First Name:BRISTOL
Other - Middle Name:RENEE
Other - Last Name:LOWDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:CARILION CHILDREN'S PEDIATRIC THERAPY DEPARTMENT
Mailing Address - Street 2:4348 ELECTRIC RD, SW 1ST FLOOR
Mailing Address - City:ROANKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018
Mailing Address - Country:US
Mailing Address - Phone:540-769-0974
Mailing Address - Fax:540-857-5384
Practice Address - Street 1:CARILION CHILDREN'S PEDIATRIC THERAPY DEPARTMENT
Practice Address - Street 2:4348 ELECTRIC RD, SW 1ST FLOOR
Practice Address - City:ROANKE
Practice Address - State:VA
Practice Address - Zip Code:24018
Practice Address - Country:US
Practice Address - Phone:540-769-0974
Practice Address - Fax:540-857-5384
Is Sole Proprietor?:No
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202011852235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist