Individual
STEPHANIE BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1310 N HEARNE AVE, SHREVEPORT, LA 71107-6516
(318) 676-5111
Mailing address
2525 YOUREE DR STE 110, SHREVEPORT, LA 71104-3600
(318) 742-3408
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7522
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
10/14/2016
Last updated
01/22/2024
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