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MARTHA BRADLEY
Mental Health >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1235780776
Individual Registrant: MARTHA BRADLEY
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
100 GLENDALOUGH CT STE E TYRONE, GA 30290-2942 US
Tel: 770-683-9375 Fax: --
Tel: 770-683-9375 Fax: --
Contact information for business:
100 GLENDALOUGH CT STE E TYRONE, GA 30290-2942 US
Tel: 770-683-9375 Fax: --
Tel: 770-683-9375 Fax: --
Registration Information:
NPI: 1235780776
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YM0800X | Behavioral Health & Social Service Providers Counselor Mental Health | GA | APC6784 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
