Individual
KESHA L BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LGSW
Contact information
Practice address
4315 IRVING AVE N, MINNEAPOLIS, MN 55412-1258
(612) 703-2618
Mailing address
4315 IRVING AVE N, MINNEAPOLIS, MN 55412-1258
(612) 703-2618
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
29289
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780014522
—
WA
Enumeration date
09/30/2020
Last updated
11/27/2023
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