Provider Demographics
NPI:1245925338
Name:BRADLEY, ABBIGALE M (BA)
Entity type:Individual
Prefix:
First Name:ABBIGALE
Middle Name:M
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 5TH AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:PATTON
Mailing Address - State:PA
Mailing Address - Zip Code:16668-1348
Mailing Address - Country:US
Mailing Address - Phone:814-631-2732
Mailing Address - Fax:
Practice Address - Street 1:3438 ROUTE 764
Practice Address - Street 2:
Practice Address - City:DUNCANSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16635-7803
Practice Address - Country:US
Practice Address - Phone:814-944-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)