| NPI | 1184343402 |
|---|---|
| Former Name | TAMARIE MAURENE BRADLEY-SULLIVAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH16721) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NC 20263) |
| Enumeration Date | 2022-08-22 |
| Last Update Date | 2025-10-30 |