Martin, William Bradley
Martin, William Bradley is an individual health care provider with primary practice located at 1390 E 20Th St , Farmington NM 87401-9037. He recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as his primary health care specialty. Martin, William Bradley can be contacted via phone (505) 599-8535.Contact Information
Primary practice address
1390 E 20Th St
Farmington NM 87401-9037
Phone: (505) 599-8535
Fax: (505) 599-8536
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 1425 | New Mexico |
Profile Details
| NPI number | 1477674760 |
|---|---|
| LBN Legal business name | Martin, William Bradley |
| Credentials | MA CCC-SLP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 3rd, 2007 |
| Last updated | Jul 9th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477674760 | NPPES |
| New Mexico | MEDICAID | K2563 |
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