Individual
RAQUEL BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14586 W PORT AU PRINCE LN, SURPRISE, AZ 85379-8551
(623) 238-4187
Mailing address
14586 W PORT AU PRINCE LN, SURPRISE, AZ 85379-8551
(623) 238-4187
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4475510
AZ
Other
Enumeration date
12/30/2014
Last updated
12/30/2014
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