Provider Demographics
NPI:1760084537
Name:BRADBURY, JULIA (LAMFT, MT-BC)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:
Last Name:BRADBURY
Suffix:
Gender:F
Credentials:LAMFT, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-4609
Mailing Address - Country:US
Mailing Address - Phone:856-693-5775
Mailing Address - Fax:856-415-7574
Practice Address - Street 1:1 S BROAD ST
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-4609
Practice Address - Country:US
Practice Address - Phone:856-693-5775
Practice Address - Fax:856-415-7574
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37FA00016800106H00000X
PA12130225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist