Individual
EMILIE ADELE BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1325 JAMISON AVE SE, ROANOKE, VA 24013-2015
(833) 952-0829
Mailing address
4069 POSTAL DR., PO BOX 21154, ROANOKE, VA 24018-9998
(540) 494-2452
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/22/2022
Last updated
07/10/2023
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