| Doctor Name: | MICHELLE BRADFORD |
| NPI Number: | 1215279211 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSHCM |
| License Number: | |
| Business Practice Address: | 6351 Main St Zachary, LA - 707914038 |
| Business Phone Number: | 2253062000 |
| Business Fax Number: | |
| Mailing Address: | Po Box 770, ZACHARY |
| State: | LA |
| Postal Code: | 707910770 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/18/2013 |
| NPI Last Update Date: | 03/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133NN1002X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Nutritionist |
| Taxonomy Specialization: | Nutrition, Education |
| Taxonomy Definition: | |