Provider Demographics
NPI:1306542097
Name:CARLILE, BRIDGET CAITLYN (SLP)
Entity type:Individual
Prefix:MS
First Name:BRIDGET
Middle Name:CAITLYN
Last Name:CARLILE
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Gender:F
Credentials:SLP
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Mailing Address - Street 1:4444 FOREST PARK AVE
Mailing Address - Street 2:CB 8502
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2212
Mailing Address - Country:US
Mailing Address - Phone:314-286-1940
Mailing Address - Fax:314-286-1473
Practice Address - Street 1:4240 DUNCAN AVE
Practice Address - Street 2:DEPT PHYSICAL THERAPY, STE 120
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1101
Practice Address - Country:US
Practice Address - Phone:314-286-1940
Practice Address - Fax:314-286-1473
Is Sole Proprietor?:No
Enumeration Date:2023-02-03
Last Update Date:2023-03-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2019044103235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist