Individual
KELLY BRADHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MT-BC
Contact information
Practice address
5900 E THOMAS RD APT G103, SCOTTSDALE, AZ 85251-7540
(623) 205-2747
Mailing address
5900 E THOMAS RD APT G103, SCOTTSDALE, AZ 85251-7540
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
14053
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14053
MUSIC THERAPY BOARD CERTIFICATION (CBMT)
—
Enumeration date
06/03/2021
Last updated
06/03/2021
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