Doctor Name: | MRS. MICHELE NICOLE BRADFORD |
NPI Number: | 1205184660 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMFTI |
License Number: | 1726 |
Business Practice Address: | 435 Clark Rd Jacksonville, FL - 322185596 |
Business Phone Number: | 9047650665 |
Business Fax Number: | |
Mailing Address: | 2573 Minosa Cir N, JACKSONVILLE |
State: | FL |
Postal Code: | 322092463 |
Phone Number: | 9047053400 |
Fax Number: | |
NPI Enumeration Date: | 08/16/2012 |
NPI Last Update Date: | 08/16/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 1726 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |