Basic Information
| Provider Information | |||||||||
| NPI: | 1508076662 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRADFIELD | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2161 DUSTIN MORGAN LOOP | ||||||||
| Address2: | |||||||||
| City: | OPELOUSAS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705706952 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3375948240 | ||||||||
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| Practice Location | |||||||||
| Address1: | 130 S 3RD ST | ||||||||
| Address2: | |||||||||
| City: | EUNICE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705354614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3374573000 | ||||||||
| FaxNumber: | 3374573055 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 808 | LA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.