Individual
MISTY TASHINA BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
75-127 LUNAPULE RD STE 4B, KAILUA KONA, HI 96740-2119
(808) 345-3863
Mailing address
75-6104 KIPEHI PL, KAILUA KONA, HI 96740-7959
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
PRE-LICENCED
HI
225700000X
Massage Therapist
Primary
MAT-15794
HI
Other
Enumeration date
03/13/2022
Last updated
04/26/2024
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