Individual
JENNIFER K BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2013035767
MO
1041C0700X
Clinical Social Worker
149015702
IL
Other
Enumeration date
09/21/2010
Last updated
10/19/2023
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