Individual
CYNTHIA E BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICDC
Contact information
Practice address
65 MESSIMER DR, NEWARK, OH 43055-1874
(740) 522-8477
(740) 788-3424
Mailing address
PO BOX 4670, NEWARK, OH 43058-4670
(740) 522-8477
(740) 788-3424
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ICDC.976061
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2485734
—
OH
Enumeration date
04/26/2012
Last updated
04/26/2012
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