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1184192981
KEVIN BRADLEY
FAIRFAX, VA
NPI
1184192981
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: VA 0904010765)
Enumeration Date
2018-11-09
Last Update Date
2018-11-09
Business Address
KEVIN BRADLEY LCSW
12408 ALEXANDER CORNELL DR
FAIRFAX, VA 22033-2414
Phone number: 703-658-9054
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Mailing Address
KEVIN BRADLEY LCSW
12408 ALEXANDER CORNELL DR
FAIRFAX, VA 22033-2414
Phone number: 703-658-9054
Copy
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