Individual
DEANNA MICHELE BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
272 COUNTY FARM RD, DOVER, NH 03820-6003
(603) 516-8173
Mailing address
272 COUNTY FARM RD, DOVER, NH 03820-6003
(603) 516-8160
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1072
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3097970
—
NH
Enumeration date
03/26/2019
Last updated
03/26/2019
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