Provider Demographics
NPI:1740482322
Name:BRADFORD, KAREN LYNN
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LYNN
Last Name:BRADFORD
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 1:72 MOUNT DESERT DR
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-2326
Mailing Address - Country:US
Mailing Address - Phone:207-947-5970
Mailing Address - Fax:
Practice Address - Street 1:72 MOUNT DESERT DR
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-2326
Practice Address - Country:US
Practice Address - Phone:207-947-5970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor