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Individual

ALLYANA CELEST BRADLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
733 DANTE ST, NEW ORLEANS, LA 70118-1013
(504) 517-1711
Mailing address
2632 REPUBLIC ST, NEW ORLEANS, LA 70119-1321
(303) 944-2575

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
151770725
CO

Other

Enumeration date
05/16/2020
Last updated
05/16/2020
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