Individual
CORETTA ANVIS BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
841 CENTENNIAL DR, COLUMBIA, SC 29229-7023
(803) 727-8312
Mailing address
841 CENTENNIAL DR, COLUMBIA, SC 29229-7023
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10583
SC
Other
Enumeration date
02/20/2018
Last updated
02/20/2018
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