Individual
NICOLE LATRICE BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
840 FOXWORTH BLVD APT 215, LOMBARD, IL 60148-4897
(630) 781-1040
Mailing address
840 FOXWORTH BLVD APT 215, LOMBARD, IL 60148-4897
Taxonomy
Speciality
Code
Description
License number
State
224ZE0001X
Environmental Modification Occupational Therapy Assistant
Primary
057004391
IL
Other
Enumeration date
07/28/2025
Last updated
07/28/2025
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