Organization
JACQUELINE BRADLEY-DIVER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELINE ANN BRADLEY-DIVER MA (BEHAVIOR SPECIALIST - MT)
(610) 357-1817
Entity
Organization
Contact information
Practice address
416 TROLLEY WAY, WEST CHESTER, PA 19382-4310
(610) 357-1817
Mailing address
416 TROLLEY WAY, WEST CHESTER, PA 19382-4310
(610) 357-1817
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/21/2012
Last updated
10/21/2012
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