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Individual
TINZLEY JUANITA BRADFORD
Active
Individual
TINZLEY JUANITA BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
WELLNESS COACH
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
052362191
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
052362191
DRIVERS LICENSE
GA
Enumeration date
10/19/2021
Last updated
10/19/2021
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