| NPI | 1558750588 |
|---|---|
| Former Name | AMANDA LEIGH BRADLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NH 1081) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ME CC6401) |
| 101YM0800X Counselor, Mental Health (Licence: MA 13010-MH-CC) | |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2023-02-02 |