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Individual

LAUREN SISK BRADFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSOTR/L

Contact information

Practice address
11 CENTRE ST, SUITE 7, SALEM, CT 06420-3844
(860) 949-2561
Mailing address
67 OCONNELL RD, COLCHESTER, CT 06415-1727
(860) 575-1567

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
001152
CT
225X00000X
Occupational Therapist
Primary
4259
CT

Other

Enumeration date
11/27/2012
Last updated
06/14/2014
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