Bradley, Jeanine M

Bradley, Jeanine M is an individual health care provider with primary practice located at 1110 N Westwood Blvd , Poplar Bluff MO 63901-3336. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Bradley, Jeanine M can be contacted via phone (573) 785-6707.

Contact Information

Primary practice address
1110 N Westwood Blvd Poplar Bluff MO 63901-3336
Phone: (573) 785-6707
Fax: (573) 785-0336
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 111864 Missouri

Profile Details

NPI number 1881734051
LBN Legal business name Bradley, Jeanine M
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881734051 NPPES
Missouri Other 111864 SPEECH LICENSE

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