Individual
KIMBERLY BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12152955
GA
106S00000X
Behavior Technician
18-49336
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619598612
—
GA
Enumeration date
04/30/2020
Last updated
10/24/2025
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