Individual
DR. STACY DENISE BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
620 TOM HUNTER RD, CHARLOTTE, NC 28213-5511
(276) 601-6197
Mailing address
5261 CARROLLTON PIKE, SUITE E, WOODLAWN, VA 24381
(276) 601-6197
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2845
NC
103TC0700X
Clinical Psychologist
2845
NC
Other
Enumeration date
03/19/2007
Last updated
09/01/2023
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