Individual
BRADLEE JAYDE MIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
300 SCHUYLKILL MEDICAL PLZ, POTTSVILLE, PA 17901-3668
(570) 621-9500
(570) 621-9510
Mailing address
12 HICKORY TER, WELLSBORO, PA 16901-1300
(570) 337-4487
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
PSL000361
PA
235Z00000X
Speech-Language Pathologist
Primary
SL014647
PA
Other
Enumeration date
07/15/2019
Last updated
05/18/2020
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