Bradford Coleman
Counselor, Mental Health in Valdosta, GA. Individual provider (NPI-1).
NPI number1104241975
StatusActive
Last updated in NPPESJul 9, 2019
Details
- NPI
- 1104241975
- Entity type
- Individual (NPI-1)
- Name
- Bradford Coleman
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 3, 2014
- Last updated
- Jul 9, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | LPC010091 | GA | Yes |
Practice location
1805 Green CirValdosta, GA 31602-2734
Phone 229-415-7621
Mailing address
1805 Green CirValdosta, GA 31602-2734
Phone 229-415-7621
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