Lori A Bradbury, MS CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Greencastle, IN

NPI 1679871685 · NPPES record last updated Mar 1, 2011

Key facts

NPI
1679871685
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
22004711A (IN)
Practice address
1014 Mill Pond Lane
Greencastle, IN 46135
Phone
(765) 653-4397
NPI assigned
Mar 1, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
22004711AINMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 22004711A IN Yes

Addresses

Primary practice location

1014 Mill Pond Lane
Greencastle, IN 46135

Mailing address

9720 Lehman Rd
Worthington, IN 47471
Phone (309) 287-9431

Other providers in Greencastle, IN

All providers in Greencastle, IN · Speech-Language Pathologist in Indiana

Sources for this page

Verify at the official NPI Registry.