Most Relevant Information
Provider Data
| NPI Number: | 1003476987 |
| Provider Name: | BENNETTA KAY BRADFORD |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/13/2019 |
| Last Updated: | 06/13/2019 |
Provider Practice Location
22001 FAIRMOUNT BLVD
SHAKER HTS
OH
441184819
Practice Location Phone/Fax
| Phone: | 2169322800 |
| Fax: |
Provider Mailing Location
22001 FAIRMOUNT BLVD
SHAKER HTS
OH
441184819
Provider Mailing Phone/Fax
| Phone: | 2169322800 |
| Fax: |