Individual
MRS. CAROLYN SUSANNE BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
4239 FARNAM, SUITE #509, OMAHA, NE 68131
(402) 551-7338
Mailing address
1009 CREST RD, PAPILLION, NE 68046
(402) 884-7893
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
001805
IA
235Z00000X
Speech-Language Pathologist
Primary
1055
NE
Other
Enumeration date
08/21/2007
Last updated
08/21/2007
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