Individual
CORY LEA BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
992 W IDAHO AVE, ONTARIO, OR 97914-2111
(208) 405-0020
(208) 739-4425
Mailing address
1901 N LAKES PL, MERIDIAN, ID 83646-5939
(208) 890-7165
(208) 739-4425
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW-43072
ID
Other
Enumeration date
08/23/2021
Last updated
05/13/2023
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