Provider Demographics
NPI:1518291962
Name:BRADLEY, MADELINE HUNT (PHD)
Entity Type:Individual
Prefix:DR
First Name:MADELINE
Middle Name:HUNT
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 E MAXWELL ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-6432
Mailing Address - Country:US
Mailing Address - Phone:859-233-3390
Mailing Address - Fax:859-243-9906
Practice Address - Street 1:520 E MAXWELL ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-6432
Practice Address - Country:US
Practice Address - Phone:859-233-3390
Practice Address - Fax:859-243-9906
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1558103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist