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General NPI Number Information
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NPI Number | 1477146967
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Entity Type | Individual
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Provider Name | DEBORAH BRADFIELD LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/16/2021
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Last Update Date | 02/16/2021
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Provider Practice Location Address
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Address Line | 402 VALLEY RD
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City | CANON CITY
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State | CO
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Zip | 81212-4176
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Country | US
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Telephone | 719-269-6889
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Fax |
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Provider Business Mailing Address
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Address Line | 102 YUCCA AVE
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City | FLORENCE
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State | CO
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Zip | 81226-9548
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Country | US
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Telephone | 719-269-6889
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW.00000711
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License Number State | CO
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