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General NPI Number Information
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NPI Number | 1881299121
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Entity Type | Individual
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Provider Name | CHRISTIN JR. BRADLEY PH.D
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Gender | Female
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Dates
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Enumeration Date | 12/03/2020
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Last Update Date | 12/03/2020
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Provider Practice Location Address
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Address Line | 8055 WINDROSE AVE APT 4143
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City | PLANO
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State | TX
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Zip | 75024-0301
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Country | US
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Telephone | 910-987-7304
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Fax |
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Provider Business Mailing Address
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Address Line | 4760 PRESTON RD STE 244-222
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City | FRISCO
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State | TX
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Zip | 75034-8548
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Country | US
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Telephone | 910-987-7304
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number | 019899
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number | 019899
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License Number State | TX
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