| NPI | 1578607404 |
|---|---|
| Former Name | HEATHER ALLENE BRADLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KS LCPC 2335) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2004037143) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2014-06-26 |