Individual
JAQUELENE VILLA BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 VETERANS DR, LEXINGTON, KY 40502-2235
(859) 233-4511
Mailing address
1101 VETERANS DRIVE, MAIL STOP 116A5-LD, LEXINGTON, KY 40502
(859) 233-4511
(859) 281-3982
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6084
KY
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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