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General NPI Number Information
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NPI Number | 1962947549
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Entity Type | Individual
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Provider Name | MARSHA BRADFORD LPC
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Gender | Female
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Dates
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Enumeration Date | 01/05/2017
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Last Update Date | 01/05/2017
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Provider Practice Location Address
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Address Line | 805 SANDYLAND DR
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City | LUFKIN
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State | TX
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Zip | 75904-5700
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Country | US
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Telephone | 936-414-2565
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Fax | 936-622-6810
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Provider Business Mailing Address
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Address Line | 911 E LUFKIN AVE
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City | LUFKIN
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State | TX
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Zip | 75901-0435
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Country | US
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Telephone | 936-699-1030
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Fax | 936-622-6810
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 7095
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License Number State | TX
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