Dedra Bradham, M.A.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP006318 Issued in GA

Practice address

9 Lacrue St.
Concordville, PA 19331

Phone

(800) 578-7906

NPI assigned

Oct 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Educational Based Services

  dba EBS Early Intervention

  • Early Intervention Provider Agency
  • West Chester, PA
  • NPI 1326092602

  Speech-Language Pathologist

  NPD (past)
• Hear to Speak

  • Speech-Language Pathologist
  • Atlanta, GA
  • NPI 1184095382
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598841546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7",
            "city": "CONCORDVILLE",
            "state": "PA",
            "postal_code": "193310007",
            "telephone_number": "800-578-7906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 LACRUE ST.",
            "city": "CONCORDVILLE",
            "state": "PA",
            "postal_code": "19331",
            "telephone_number": "800-578-7906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADHAM",
        "first_name": "DEDRA",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP006318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Bartley
• Greta Bearce
• Samuel P. Cimino, DDS
• Concordville Fire and Protective Association
• Concordville Pharmacy Inc
• Michelle Cooper, MED CCC-SLP
• Francis Joseph D'Allura, BS

• Speech-Language Pathologist in Concordville, PA
• Providers in Concordville, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.