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Individual

CRYSTAL D BRADSHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
3225 SHALLOWFORD RD STE 710, SUITE 114 #203, MARIETTA, GA 30062
(770) 364-9005
Mailing address
12195 HIGHWAY 92, SUITE 114 #203, WOODSTOCK, GA 30188
(770) 364-9005

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC006953
GA

Other

Enumeration date
08/27/2009
Last updated
03/05/2021
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