Individual
MS. MARY A BRADLEY
Active
Individual
MS. MARY A BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSCSW, LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2011022083
MO
1041C0700X
Clinical Social Worker
4026
KS
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
2011022083
MO
Other
Enumeration date
01/18/2011
Last updated
03/08/2013
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