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Individual
MARY C BRADLEY
Active
Individual
MARY C BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC, LPC, LMFT
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2927
TX
101YP2500X
Professional Counselor
Primary
9398
TX
106H00000X
Marriage & Family Therapist
001122
TX
Other
Enumeration date
09/08/2011
Last updated
05/26/2021
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