NPI 1396043857 · live from the CMS NPI Registry
Irene Louise Bradford
Social Worker, Clinical in Salt Lake City, UT. National Provider Identifier 1396043857, active.
NPI record
| NPI | 1396043857 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 1020 S Main St Ste 100, Salt Lake City, UT 84101 |
| Practice phone | 888-948-4864 |
| Mailing address | Po Box 572070, Murray, UT 84157 |
| Enumerated | March 8, 2011 |
| Last updated | November 9, 2018 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst | 103K00000X | 101y00000x-counselor (UT) |
| Social Worker, Clinical primary | 1041C0700X | 9466365-3501 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.