Individual
MISTY MELISSA BRADY-LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
4736 GRAND MASTERS WAY, WOODBRIDGE, VA 22192
(979) 574-9568
Mailing address
4736 GRAND MASTERS WAY, WOODBRIDGE, VA 22192
(979) 574-9568
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0701009284
VA
101YM0800X
Mental Health Counselor
37AC00366100
NJ
Other
Enumeration date
06/08/2017
Last updated
09/24/2020
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