Individual
DR. KELLY E BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
6640 INTECH BLVD STE 195, INDIANAPOLIS, IN 46278-2014
(317) 295-0608
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
Primary
20043645A
IN
103TC0700X
Clinical Psychologist
20043645A
IN
Other
Enumeration date
09/02/2014
Last updated
01/11/2023
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