| NPI | 1497050439 |
|---|---|
| Former Name | CARRIE BRADLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IN 39002468A) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2011-01-24 |
| Last Update Date | 2023-10-05 |