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Individual

PORSHA BRADLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1970 ST. LANDRY HWY, ST. LANDRY, LA 71367-3034
(504) 236-8783
(318) 253-2222
Mailing address
1970 ST. LANDRY HWY, ST. LANDRY, LA 71367-3034
(504) 236-8783
(318) 253-2222

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NONE
LA
Enumeration date
03/17/2016
Last updated
03/17/2016
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