Provider Demographics
NPI:1942967005
Name:BRADLEY, JULIET (MS)
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2162 SPANISH BAY CT
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-0711
Mailing Address - Country:US
Mailing Address - Phone:626-543-0382
Mailing Address - Fax:
Practice Address - Street 1:2162 SPANISH BAY CT
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-0711
Practice Address - Country:US
Practice Address - Phone:626-543-0382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist