Provider Demographics
NPI:1992113021
Name:BIXEL, BRIDGET EVE
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:EVE
Last Name:BIXEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 AVONDALE LN
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71112-4247
Mailing Address - Country:US
Mailing Address - Phone:302-290-0217
Mailing Address - Fax:
Practice Address - Street 1:367 AVONDALE LN
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71112-4247
Practice Address - Country:US
Practice Address - Phone:302-290-0217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-01
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP27189235Z00000X
DEO1-0001409235Z00000X
LA7907235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist