Provider Demographics
NPI:1336326826
Name:BRADY-CIARCIA, PATRICIA M (MS)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:M
Last Name:BRADY-CIARCIA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 BRADLEE RD
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-3111
Mailing Address - Country:US
Mailing Address - Phone:781-395-0274
Mailing Address - Fax:
Practice Address - Street 1:16 BRADLEE RD
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-3111
Practice Address - Country:US
Practice Address - Phone:781-395-0274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA533106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist