Individual
MRS. LISA BAZZANO BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
3462 ESSEX AVE, ATLANTA, GA 30339-5752
(678) 612-6023
(770) 980-1293
Mailing address
3462 ESSEX AVE, ATLANTA, GA 30339-5752
(678) 612-6023
(770) 980-1293
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP003520
GA
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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