Individual
BRADFORD COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1805 GREEN CIR, VALDOSTA, GA 31602-2734
(229) 415-7621
Mailing address
1805 GREEN CIR, VALDOSTA, GA 31602-2734
(229) 415-7621
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC010091
GA
Other
Enumeration date
03/03/2014
Last updated
07/09/2019
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