Individual
DEIRDRE VANESSA BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
140 MAYLYN AVE, DALLASTOWN, PA 17313-9208
(443) 756-4472
Mailing address
140 MAYLYN AVE, DALLASTOWN, PA 17313-9208
(443) 756-4472
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MSG002269
PA
Other
Enumeration date
01/16/2013
Last updated
01/16/2013
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