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NPI Code Detail

MEDICARE: ERICA BRADLEY

MEDICARE: ERICA BRADLEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1225482235
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA BRADLEY
Provider Business Mailing Address
First Line : 4721 READING RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45237-6107
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3650 MUDDY CREEK RD STE 100
Second Line :
City : CINCINNATI
State : OH
Zip : 45238-2058
Country : US
Telephone Number : 513-347-0375
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2016
Last Update Date : 07/05/2024

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Directions to “ ERICA BRADLEY ” Practice Location

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