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Individual

MR. BRADLEY KEBODEAUX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
2100 E CHAMBERS DR, BOONEVILLE, MS 38829-8938
(662) 728-3174
(662) 728-3175
Mailing address
303 N MADISON ST, CORINTH, MS 38834-5072
(662) 286-9883
(662) 286-8095

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
Primary
1633
MS

Other

Enumeration date
04/22/2010
Last updated
08/26/2016
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