Reed Evan Bradford, PH.D.
Individual provider Active NPI Psychologist · Brandon, MS
NPI 1194032862 · NPPES record last updated Jan 27, 2011
Key facts
- NPI
- 1194032862
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 33-541 (MS)
- Practice address
- 103 Bridgepointe Blvd
Brandon, MS 39047-7001 - Phone
- (601) 201-8397
- NPI assigned
- Sep 1, 2010
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 33-541 | MS | Yes |
Addresses
Primary practice location
103 Bridgepointe Blvd
Brandon, MS 39047-7001
Mailing address
103 Bridgepointe Blvd
Brandon, MS 39047-7001
Phone (601) 201-8397
Other providers in Brandon, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.