Individual
REBECCA R BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, LMFT,LMHC, NCC
Contact information
Practice address
1250 W IRONWOOD DR STE 330, COEUR D ALENE, ID 83814-2682
(208) 274-3020
(208) 561-7081
Mailing address
1250 W IRONWOOD DR STE 330, COEUR D ALENE, ID 83814-2682
(208) 274-3020
(208) 561-7081
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LCPC-9186
ID
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
05/08/2019
Last updated
10/02/2024
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