NPI 1700425980 · live from the CMS NPI Registry
Nicole Annette Bradley
Behavior Analyst in South Portland, ME. National Provider Identifier 1700425980, active.
NPI record
| NPI | 1700425980 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 50 Donald B Dean Dr Ste B, South Portland, ME 04106 |
| Practice phone | 207-274-2528 |
| Mailing address | 21600 Oxnard St, Woodland Hills, CA 91367 |
| Enumerated | January 5, 2020 |
| Last updated | January 5, 2020 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | 2712338 (ME) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.