Individual
LORI BRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5401 ROGERS AVE STE 200, FORT SMITH, AR 72903-3763
(479) 414-7581
Mailing address
1808 BUNKER HILL DRIVE, VAN BUREN, AR 72956
(479) 414-7581
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
A1512160
AR
Other
Enumeration date
12/29/2015
Last updated
12/29/2015
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