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Individual

COLLEEN BRADLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.E.D

Contact information

Practice address
8 SERPENTINE LN, LEVITTOWN, NY 11756-3804
(516) 506-8060
(516) 465-9834
Mailing address
8 SERPENTINE LN, LEVITTOWN, NY 11756-3804
(516) 506-8060
(516) 465-9834

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
776443
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14379270
NEW YORK STATE DEPARTMENT OF HEALTH
NY
Enumeration date
07/20/2012
Last updated
07/22/2012
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