Individual
SHANNON JOY BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
220 W GEORGIA AVE, NAMPA, ID 83686-2835
(208) 960-7474
Mailing address
220 W GEORGIA AVE, NAMPA, ID 83686-2835
(208) 960-7474
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
05/19/2021
Last updated
01/22/2026
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