Individual
ERIN BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC,SLP
Contact information
Practice address
1405 SOLANA DR, BELMONT, CA 94002-3653
(650) 592-7570
(650) 591-3114
Mailing address
1405 SOLANA DR, BELMONT, CA 94002-3653
(650) 592-7570
(650) 591-3114
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
17166
CA
235Z00000X
Speech-Language Pathologist
SLP004640
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000947053A
—
GA
01
—
582606738
TAX ID
GA
Enumeration date
01/21/2007
Last updated
12/10/2014
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