Individual
MRS. LISA BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1466 N HIGHWAY 89, SUITE 220, FARMINGTON, UT 84025-2738
(801) 451-0475
Mailing address
1060 BANBURY DR, SYRACUSE, UT 84075-9539
(801) 825-1467
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1395303501
UT
Other
Enumeration date
01/11/2007
Last updated
07/08/2007
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