| Doctor Name: | MRS. CAROLYN SUSANNE BRADLEY |
| NPI Number: | 1093908212 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS CCC SLP |
| License Number: | 001805 |
| Business Practice Address: | 4239 Farnam Suite #509 Omaha, NE - 68131 |
| Business Phone Number: | 4025517338 |
| Business Fax Number: | |
| Mailing Address: | 1009 Crest Rd, PAPILLION |
| State: | NE |
| Postal Code: | 68046 |
| Phone Number: | 4028847893 |
| Fax Number: | |
| NPI Enumeration Date: | 08/21/2007 |
| NPI Last Update Date: | 08/21/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 001805 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |