NPI | 1093301400 |
---|---|
Professional Name | ODESSA RENE BRADLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 251E00000X Home Health (Licence: AL 4179) |
Additional Taxonomies | 251E00000X Home Health (Licence: AL 20213979) |
374U00000X Home Health Aide (Licence: AL 20213537) | |
Enumeration Date | 2020-12-19 |
Last Update Date | 2021-05-28 |