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1801305081
HEATHER BRADDOCK
KINGSPORT, TN
NPI
1801305081
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: TN 3949)
Enumeration Date
2017-09-20
Last Update Date
2017-09-20
Business Address
HEATHER BRADDOCK LPC-MHSP
441 CLAY ST
KINGSPORT, TN 37660-3693
Phone number: 423-247-4536
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Mailing Address
HEATHER BRADDOCK LPC-MHSP
PO BOX 1323
KINGSPORT, TN 37662-1323
Phone number: 423-247-4536
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