Individual
MS. RANDI DAWN BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, LCMT, CRM, MMP
Contact information
Practice address
1213 LASKIN RD, VIRGINIA BEACH, VA 23451-5260
(757) 621-9615
Mailing address
426 RENNIE CT, VIRGINIA BEACH, VA 23454-3946
(757) 621-9615
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
0019011982
VA
225700000X
Massage Therapist
0019011982
VA
Other
Enumeration date
10/08/2018
Last updated
09/23/2019
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