Individual
DR. MICHELLE BRADHAM-COUSAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, CRC, LMHC, NCC
Contact information
Practice address
1503 S US 301 UNIT 92, TAMPA, FL 33619
(941) 250-5446
Mailing address
10121 E ADAMO DR UNIT 89761, TAMPA, FL 33689-9038
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
FL
172V00000X
Community Health Worker
—
FL
225C00000X
Rehabilitation Counselor
Primary
00102595
FL
Other
Enumeration date
02/11/2022
Last updated
02/11/2022
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