Individual
LAUREN SISK BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOTR/L
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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