Individual
MRS. TALYA DAWN BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
877 BALTIMORE ANNAPOLIS BLVD STE 308, SEVERNA PARK, MD 21146-4716
(443) 871-8815
Mailing address
789 OAK STUMP DR, MILLERSVILLE, MD 21108-1850
(443) 871-8815
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC3182
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0385921 00
—
MD
05
—
654699
—
MD
Enumeration date
07/06/2009
Last updated
06/26/2024
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