Individual
JESSICA L BRADWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1310 W MAIN ST STE 100, RUSSELLVILLE, AR 72801-2803
(479) 964-2011
Mailing address
2412 N 55TH LN, FORT SMITH, AR 72904-5840
(850) 693-5271
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/15/2022
Last updated
07/30/2024
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