Individual
JESSICA LATISHA BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7 GRAND TETON AVE, HOWELL, NJ 07731-9002
(732) 984-8064
Mailing address
7 GRAND TETON AVE, HOWELL, NJ 07731-9002
(732) 984-8064
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SC05977700
NJ
Other
Enumeration date
02/21/2019
Last updated
04/28/2021
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