Individual
MS. KATHLEEN LOUISE BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P. T.
Contact information
Practice address
991 PARALLEL DR, LAKEPORT, CA 95453
(707) 263-4338
Mailing address
P.O. BOX 671, COBB, CA 95426-0671
(707) 928-6712
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT 30664
CA
Other
Enumeration date
01/05/2007
Last updated
07/08/2007
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