| Doctor Name: | KIRA S BRADLEY |
| NPI Number: | 1023301405 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CACII |
| License Number: | 1906 |
| Business Practice Address: | 5524 Old National Hwy College Park, GA - 303493212 |
| Business Phone Number: | 4047638555 |
| Business Fax Number: | 4047638502 |
| Mailing Address: | 737 Peteywood Dr, AUSTELL |
| State: | GA |
| Postal Code: | 301068505 |
| Phone Number: | 7704322776 |
| Fax Number: | |
| NPI Enumeration Date: | 05/18/2011 |
| NPI Last Update Date: | 05/18/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 1906 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |