Individual
JATAVIA BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
350 SUN TEMPLE DR, MADISON, AL 35758-5919
(256) 288-3333
(256) 429-9411
Mailing address
600 SUN TEMPLE DR, MADISON, AL 35758-8643
(256) 975-4291
(256) 325-1890
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
5585
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
330000014
—
AL
Enumeration date
03/06/2019
Last updated
05/01/2025
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