Individual
MRS. TERRY DENISE BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
2431 W MAIN ST, SUITE 603, DOTHAN, AL 36301-1217
(334) 673-8869
(334) 673-8851
Mailing address
2431 W MAIN ST, SUITE 603, DOTHAN, AL 36301-1217
(334) 673-8869
(334) 673-8851
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1784
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-34689
BCBS OF AL
AL
Enumeration date
06/03/2006
Last updated
09/04/2007
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