Provider Demographics
NPI:1861541500
Name:FOWLER, BRIDGETTE ANN (AUDIOLOGIST)
Entity type:Individual
Prefix:MRS
First Name:BRIDGETTE
Middle Name:ANN
Last Name:FOWLER
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Gender:F
Credentials:AUDIOLOGIST
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Mailing Address - Street 1:5219 HICKORY PARK DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-2618
Mailing Address - Country:US
Mailing Address - Phone:804-228-4480
Mailing Address - Fax:804-228-4484
Practice Address - Street 1:5219 HICKORY PARK DR
Practice Address - Street 2:SUITE C
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-2618
Practice Address - Country:US
Practice Address - Phone:804-228-4480
Practice Address - Fax:804-228-4484
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2010-11-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA2201000372231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist