Provider Demographics
NPI:1982922688
Name:BRADY, HARRIET IRENE (TEACHER)
Entity Type:Individual
Prefix:MS
First Name:HARRIET
Middle Name:IRENE
Last Name:BRADY
Suffix:
Gender:F
Credentials:TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 280
Mailing Address - Street 2:104 BIG BEND RANCH ROAD
Mailing Address - City:WADSWORTH
Mailing Address - State:NV
Mailing Address - Zip Code:89442-0280
Mailing Address - Country:US
Mailing Address - Phone:775-352-6842
Mailing Address - Fax:775-575-3180
Practice Address - Street 1:104 BIG BEND RANCH ROAD
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:NV
Practice Address - Zip Code:89442-0280
Practice Address - Country:US
Practice Address - Phone:775-352-6842
Practice Address - Fax:775-575-3180
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0000041845174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator