Provider Demographics
NPI:1689880700
Name:BRADLEY, BETTY CATHARINE
Entity Type:Individual
Prefix:MS
First Name:BETTY
Middle Name:CATHARINE
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 BENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-9762
Mailing Address - Country:US
Mailing Address - Phone:828-658-0577
Mailing Address - Fax:
Practice Address - Street 1:1617 HENDERSONVILLE RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3454
Practice Address - Country:US
Practice Address - Phone:828-274-1531
Practice Address - Fax:828-277-3701
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5710235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist