Doctor Name: | MS. ANTOINETTE BRADLEY |
NPI Number: | 1215094529 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW, SAP, |
License Number: | 3640 |
Business Practice Address: | 306 Airport Dr Moncks Corner, SC - 294612629 |
Business Phone Number: | 8437618272 |
Business Fax Number: | 8437193025 |
Mailing Address: | 170 Gaines Ct, VANCE |
State: | SC |
Postal Code: | 291639452 |
Phone Number: | 8034967868 |
Fax Number: | 8437193025 |
NPI Enumeration Date: | 01/03/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 3640 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
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 |