Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Bradford Anthony Wallace Jr.

Individual provider Occupational Therapy Assistant · NPI 1609821636

Mr. Bradford Anthony Wallace Jr. is an Occupational Therapy Assistant in Newark, Delaware. Licensed in Delaware. Registered with an NPI since 2006.

Licensed in
DE
In the registry since
2006
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

130 Executive Dr
Newark, DE 19702-3349
Phone: (302) 292-3454
Fax: (302) 292-3464
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence J2-0000629 (DE)

Record details

NPI number1609821636
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 25, 2006
Last updated in NPPESJuly 13, 2026

Other providers in Newark