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Individual

HEATHER LEE BRADLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
1408 N PIEDMONT WAY, TALLAHASSEE, FL 32308-7974
(850) 692-6326
(850) 692-6976
Mailing address
1408 N PIEDMONT WAY, TALLAHASSEE, FL 32308-7974
(850) 692-6326
(850) 692-6976

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY6826
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
591917016
COMMERCIAL INSURANCE
FL
01
73127
BLUE CROSS PROVIDER NUMBE
FL
Enumeration date
08/25/2006
Last updated
12/19/2013
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