Individual
SHALON BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, BC-TMH
Contact information
Practice address
1907 PASS RD STE D, BILOXI, MS 39531-4101
(228) 300-2425
(228) 265-8117
Mailing address
108 ESTES ST, GULFPORT, MS 39503-3208
(228) 300-2425
(228) 265-8117
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2107
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03908869
—
MS
Enumeration date
06/16/2015
Last updated
06/15/2021
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