Bradley, Tara B

Bradley, Tara B is an individual health care provider with primary practice located at 5045 Carpenter Creek Dr , Pensacola FL 32503-2521. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, Speech, Language and Hearing Service Providers / Speech-Language Pathologist. Speech, Language and Hearing Service Providers / Speech-Language Pathologist is her primary health care specialty. Bradley, Tara B can be contacted via phone (850) 416-4681.

Contact Information

Primary practice address
5045 Carpenter Creek Dr Pensacola FL 32503-2521
Phone: (850) 416-4681
Fax: (850) 416-7776
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 3291 Alabama

Profile Details

NPI number 1720353246
LBN Legal business name Bradley, Tara B
Credentials MS, CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2012
Last updated Oct 6th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720353246 NPPES
Alabama Other 12140764 ASHA CERTIFICATION

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