| Doctor Name: | KAREN LYNN BRADLEY/JACKSON |
| NPI Number: | 1972892685 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 0701004867 |
| Business Practice Address: | 1113 Cedar Valley Dr. Healing Waters Counseling Center Cedar Bluff, VA - 24609 |
| Business Phone Number: | 2769630001 |
| Business Fax Number: | 2769630005 |
| Mailing Address: | 1113 Cedar Valley, Drive Healing Waters Counseling Center P.o. Box 426 CEDAR BLUFF |
| State: | VA |
| Postal Code: | 24609 |
| Phone Number: | 2769630001 |
| Fax Number: | 2769630005 |
| NPI Enumeration Date: | 04/04/2011 |
| NPI Last Update Date: | 04/03/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 0701004867 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |