Individual
TABATHA BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
204 MISSISSIPPI ST S, WYNNE, AR 72396-3025
(870) 208-8499
Mailing address
204 MISSISSIPPI ST S, WYNNE, AR 72396-3025
(870) 208-8499
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
A2406004
AR
Other
Enumeration date
06/21/2024
Last updated
06/21/2024
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