Individual
MS. MARY BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CG60735677
Contact information
Practice address
2422 96TH ST S APT J105, TACOMA, WA 98444-1782
(805) 217-5654
Mailing address
2422 96TH ST S APT J105, TACOMA, WA 98444-1782
(805) 217-5654
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
CG60735677
WA
175T00000X
Peer Specialist
Primary
CG60735677
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CG60735677
—
WA
Enumeration date
12/17/2018
Last updated
07/22/2022
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