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MS. ANITRA LYNETTE BRADFORD LAC

Mental Health >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1124218177

Individual Registrant:
MS. ANITRA LYNETTE BRADFORD LAC
Gender: F
Not Sole Proprietor

Location and contact information for practice:
621 E NORTH ST  MAGNOLIA, AR 71753-3120 US
Tel: 870-234-0739  Fax: --

Contact information for business:
1600 ALDERSGATE RD STE 200  LITTLE ROCK, AR 72205-6676 US
Tel: 501-661-0720  Fax: --

Registration Information:
NPI: 1124218177
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N101YM0800XBehavioral Health & Social Service Providers
Counselor
Mental Health
ARA0710078
Y101YP2500XBehavioral Health & Social Service Providers
Counselor
ARP1012084

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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