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Individual

MISS JESSICA TAYLER BRADFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SLPA

Contact information

Practice address
2662 S 25TH AVE, YUMA, AZ 85364-6829
(928) 287-1296
Mailing address
2662 S 25TH AVE, YUMA, AZ 85364-6829
(928) 287-1296

Taxonomy

Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA10880
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SLPA10880
AZ SLPA LICENSE
AZ
Enumeration date
10/12/2017
Last updated
10/12/2017
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