Individual
KIRA S BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CACII
Contact information
Practice address
5524 OLD NATIONAL HWY, COLLEGE PARK, GA 30349-3212
(404) 763-8555
(404) 763-8502
Mailing address
737 PETEYWOOD DR, AUSTELL, GA 30106-8505
(770) 432-2776
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1906
GA
Other
Enumeration date
05/18/2011
Last updated
05/18/2011
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