| NPI | 1609334184 |
|---|---|
| Former Name | JENNIFER ANGELYN BRADLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: WI 130712-121) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 20446) |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2023-11-22 |