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NPI Code Detail

MEDICARE: JENNIFER LYNN BRADY

MEDICARE: JENNIFER LYNN BRADY
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1730733759
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER LYNN BRADY
Provider Business Mailing Address
First Line : 325 COLUMBIA ST STE 300
Second Line :
City : HUDSON
State : NY
Zip : 12534-1931
Country : US
Telephone Number : 518-828-9446
Fax Number : 518-828-3402
Provider Business Practice Location Address
First Line : 325 COLUMBIA ST STE 300
Second Line :
City : HUDSON
State : NY
Zip : 12534-1931
Country : US
Telephone Number : 518-828-9446
Fax Number : 518-828-3402
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2019
Last Update Date : 07/29/2019

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Directions to “ JENNIFER LYNN BRADY ” Practice Location

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