Individual
MRS. KATHRINE BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR L
Contact information
Practice address
380 CANYONVIEW DR, FARMINGTON, NM 87401-8630
(505) 324-0542
Mailing address
380 CANYONVIEW DR, FARMINGTON, NM 87401-8630
(505) 324-0542
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
519
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
519
NM BOARD OF OCCUPATIONAL
NM
Enumeration date
01/31/2007
Last updated
07/08/2007
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