Johnny Ray Bradley Jr.
Counselor, Mental Health in Richmond, VA. Individual provider (NPI-1).
NPI number1124620554
StatusActive
Last updated in NPPESNov 10, 2020
Details
- NPI
- 1124620554
- Entity type
- Individual (NPI-1)
- Name
- Johnny Ray Bradley Jr.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Nov 10, 2020
- Certification date
- Nov 10, 2020
- Last updated
- Nov 10, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | VA | Yes |
Practice location
1510 Willow Lawn Dr Ste 100dRichmond, VA 23230-3429
Phone 804-512-0061 · Fax 833-881-9200
Mailing address
4220 Rosedown PlRichmond, VA 23223-5860
Other practice locations
4220 Rosedown Pl
Richmond, VA 23223-5860
Richmond, VA 23223-5860
Phone 804-512-0061
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