Individual
ANGELIA PINCKARD BRADLEY
Active
Individual
ANGELIA PINCKARD BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED LPC MHSP
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPCMHSP2004
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010277582
VIRGINIA MEDICAID CTC
—
01
—
334969
VALUEOPTIONS GROUP
—
01
—
4120940
MAGELLAN SUMMIT
—
01
—
620582605
CARITEN PHP PPO
—
01
—
9427660
PHCS
—
Enumeration date
09/12/2006
Last updated
09/15/2016
Update your record
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