Individual
JAVONTAE BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4108 PARK RD STE 410, CHARLOTTE, NC 28209-2262
(980) 949-8990
Mailing address
9404 PERIMETER STATION DR APT 303, CHARLOTTE, NC 28216-4474
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A20178
NC
Other
Enumeration date
10/14/2024
Last updated
09/11/2025
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