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Individual
STEPHANIE BRADLEY
Active
Individual
STEPHANIE BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0701006054
VA
101YP2500X
Professional Counselor
Primary
LPC008337
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003170682A
—
GA
05
—
1659424448
—
VA
Enumeration date
03/03/2015
Last updated
08/27/2022
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