Individual
MRS. LUCINDA GROSS BEDGOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., CCC-SLP
Contact information
Practice address
69 LINDSEY LANE, SUITE A, ST. MARYS, GA 31558-1702
(912) 729-2294
(912) 673-9457
Mailing address
69 LINDSEY LANE, SUITE A, ST. MARYS, GA 31558-1702
(912) 729-2294
(912) 673-9457
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP001226
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000584438E
—
GA
01
—
10059138
AMERIGROUP PROVIDER NUMBE
GA
01
—
343639
WELLCARE PROVIDER NUMBER
GA
Enumeration date
01/02/2007
Last updated
07/02/2020
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