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General NPI Number Information
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NPI Number | 1124411640
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Entity Type | Individual
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Provider Name | ANNE BRADLEY LGSW
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Gender | Female
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Dates
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Enumeration Date | 03/08/2015
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Last Update Date | 03/08/2015
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Provider Practice Location Address
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Address Line | 1443 EUCLID ST NW
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City | WASHINGTON
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State | DC
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Zip | 20009-4506
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Country | US
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Telephone | 202-285-1690
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Fax |
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Provider Business Mailing Address
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Address Line | 520 E ST NE APT. 202
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City | WASHINGTON
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State | DC
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Zip | 20002-5247
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Country | US
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Telephone | 228-806-4916
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LG50080884
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 20416
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License Number State | MD
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