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NPI Code Detail

MEDICARE: EMILY NICOLE BRADFORD PLPC

MEDICARE: EMILY NICOLE BRADFORD PLPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor2021024673MO

General Provider Information

NPI Number : 1699346304
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY NICOLE BRADFORD PLPC
Provider Business Mailing Address
First Line : 12351 W 96TH TER STE 105
Second Line :
City : LENEXA
State : KS
Zip : 66215-4410
Country : US
Telephone Number : 913-257-3161
Fax Number :
Provider Business Practice Location Address
First Line : 8350 N SAINT CLAIR AVE STE 275
Second Line :
City : KANSAS CITY
State : MO
Zip : 64151-5114
Country : US
Telephone Number : 913-257-3161
Fax Number : 888-956-8977
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2021
Last Update Date : 07/03/2021

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Directions to “ EMILY NICOLE BRADFORD PLPC” Practice Location

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