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NPI Code Detail

MEDICARE: LINDA BRADLEY

MEDICARE:   LINDA  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
1101YP2500XProfessional CounselorA11447NC
2101YP2500XProfessional CounselorA14270NC

General Provider Information

NPI Number : 1255718672
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA BRADLEY
Provider Business Mailing Address
First Line : 3405 W WENDOVER AVE
Second Line :
City : GREENSBORO
State : NC
Zip : 27407-2377
Country : US
Telephone Number : 336-323-1385
Fax Number :
Provider Business Practice Location Address
First Line : 3405 W WENDOVER AVE STE F
Second Line :
City : GREENSBORO
State : NC
Zip : 27407-1525
Country : US
Telephone Number : 336-323-1385
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2015
Last Update Date : 02/27/2019

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Directions to “ LINDA BRADLEY ” Practice Location

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