NPI 1306357173 · live from the CMS NPI Registry
Andrea R Bradford, M.S. CCC-SLP
Speech-Language Pathologist, in Fayetteville, WV. National Provider Identifier 1306357173, active.
NPI record
| NPI | 1306357173 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Speech-Language Pathologist, 235Z00000X |
| Practice location | 111 Fayette Ave, Fayetteville, WV 25840 |
| Practice phone | 304-574-1176 |
| Mailing address | 404 Old Main Dr, Summersville, WV 26651 |
| Enumerated | October 19, 2017 |
| Last updated | October 19, 2017 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Speech-Language Pathologist, primary | 235Z00000X | SLP-1826 (WV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.