Individual
JOCELYN BRADBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
119 W DEPOT ST, MOCKSVILLE, NC 27028-2327
(336) 751-5636
Mailing address
710 BARROCLIFF RD, CLEMMONS, NC 27012-8596
(336) 751-5636
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
718
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6102958
—
NC
Enumeration date
06/23/2006
Last updated
07/08/2007
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