Provider Demographics
NPI:1528261476
Name:BRADLEY, FAITH LITTLEFIELD (OT)
Entity type:Individual
Prefix:MISS
First Name:FAITH
Middle Name:LITTLEFIELD
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 WILLIAMS WAY
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-3030
Mailing Address - Country:US
Mailing Address - Phone:801-891-8922
Mailing Address - Fax:801-785-5908
Practice Address - Street 1:765 WILLIAMS WAY
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-3030
Practice Address - Country:US
Practice Address - Phone:801-891-8922
Practice Address - Fax:801-785-5908
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT347221-4201251E00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility