Individual
HEATHER R BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
7110 JORDAN DR, RAPID CITY, SD 57702
(605) 342-4412
(605) 342-4211
Mailing address
4832 JOHNSTON DR, RAPID CITY, SD 57703-6448
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5833870
—
SD
Enumeration date
03/26/2007
Last updated
07/09/2007
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