Provider Demographics
NPI:1568705853
Name:BRADFORD, HANNAH VANCE (M AC)
Entity Type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:VANCE
Last Name:BRADFORD
Suffix:
Gender:F
Credentials:M AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6311 HUNTOVER LN
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3671
Mailing Address - Country:US
Mailing Address - Phone:301-675-6778
Mailing Address - Fax:
Practice Address - Street 1:6311 HUNTOVER LN
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3671
Practice Address - Country:US
Practice Address - Phone:301-675-6778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD334171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist