MEDICARE: SELENA SKYE BRADLEY MS, CCC-SLP

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
1	235Z00000X	Speech-Language Pathologist	30002062	NC

General Provider Information

NPI Number	:	1427998251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SELENA SKYE BRADLEY MS, CCC-SLP

Provider Business Mailing Address
First Line	:	688 STARBOARD REACH
Second Line	:
City	:	LEXINGTON
State	:	NC
Zip	:	27292-6936
Country	:	US
Telephone Number	:	336-470-3036
Fax Number	:

Provider Business Practice Location Address
First Line	:	975 HEATH CHURCH RD
Second Line	:
City	:	LEXINGTON
State	:	NC
Zip	:	27292-9690
Country	:	US
Telephone Number	:	336-470-3036
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2026
Last Update Date	:	03/31/2026

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Directions to “ SELENA SKYE BRADLEY MS, CCC-SLP” Practice Location

Language	Start Address	Practice Location

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