Individual
JOHNNY RAY BRADLEY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1510 WILLOW LAWN DR STE 100D, RICHMOND, VA 23230-3429
(804) 512-0061
(833) 881-9200
Mailing address
4220 ROSEDOWN PL, RICHMOND, VA 23223-5860
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
VA
Other
Enumeration date
11/10/2020
Last updated
11/10/2020
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