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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KAREN LESLIE BRADLEY C.R.N.P. (ADMINISTRATOR)
(410) 562-6881
Entity
Organization

Contact information

Practice address
1500 PRESSTMAN ST, BALTIMORE, MD 21217-2370
(410) 225-7696
Mailing address
10 W MADISON ST, #11, BALTIMORE, MD 21201-5239
(443) 438-7863

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
904954
MD

Other

Enumeration date
06/03/2013
Last updated
12/17/2013
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