Provider Demographics
NPI:1124898218
Name:BRADFORD, BARBARA (QBHS)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:BRADFORD
Suffix:
Gender:F
Credentials:QBHS
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:
Other - Last Name:BRADFORD-WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:QBHS
Mailing Address - Street 1:6640 CLEMENT AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-4935
Mailing Address - Country:US
Mailing Address - Phone:216-355-7140
Mailing Address - Fax:
Practice Address - Street 1:6640 CLEMENT AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-4935
Practice Address - Country:US
Practice Address - Phone:216-355-7140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No172V00000XOther Service ProvidersCommunity Health Worker