| Doctor Name: | DR. JOHN MICHAEL BRADLEY |
| NPI Number: | 1356490155 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 947 |
| Business Practice Address: | 1529 River Oaks Rd W Harahan, LA - 701232162 |
| Business Phone Number: | 5048132842 |
| Business Fax Number: | 5047348826 |
| Mailing Address: | 3721 Palmyra St., NEW ORLEANS |
| State: | LA |
| Postal Code: | 70119 |
| Phone Number: | 5048132842 |
| Fax Number: | 5047348826 |
| NPI Enumeration Date: | 01/09/2007 |
| NPI Last Update Date: | 02/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 947 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |