| NPI | 1912693599 |
|---|---|
| Former Name | HEATHER C BRADLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN C2-51331) |
| Enumeration Date | 2023-04-17 |
| Last Update Date | 2023-04-17 |