Individual
IRENE LOUISE BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1020 S MAIN ST STE 100, SALT LAKE CITY, UT 84101-3194
(888) 948-4864
Mailing address
PO BOX 572070, MURRAY, UT 84157-2070
(801) 263-7100
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
101Y00000X-COUNSELOR
UT
1041C0700X
Clinical Social Worker
Primary
9466365-3501
UT
Other
Enumeration date
03/08/2011
Last updated
11/09/2018
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