Provider Demographics
NPI:1205388840
Name:BRADLEY, SIERRA (MED)
Entity Type:Individual
Prefix:MISS
First Name:SIERRA
Middle Name:
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MICHELMAN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3904
Mailing Address - Country:US
Mailing Address - Phone:570-903-4073
Mailing Address - Fax:
Practice Address - Street 1:140 HIGH ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2702
Practice Address - Country:US
Practice Address - Phone:413-772-0249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health