| Doctor Name: | SAMANTHA MARIE BRADLEY |
| NPI Number: | 1730490038 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LIMHP |
| License Number: | 9143 |
| Business Practice Address: | 710 Burlington St Holdrege, NE - 689492177 |
| Business Phone Number: | 3089956691 |
| Business Fax Number: | 3089956830 |
| Mailing Address: | 710 Burlington St, Po Box 683 HOLDREGE |
| State: | NE |
| Postal Code: | 689492177 |
| Phone Number: | 3089956691 |
| Fax Number: | 3089956830 |
| NPI Enumeration Date: | 07/01/2010 |
| NPI Last Update Date: | 05/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 9143 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |