Provider Demographics
NPI:1669078994
Name:BRADLEY, CAROL BEATRICE (EDD)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:BEATRICE
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 MCGUIRE RD
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:MA
Mailing Address - Zip Code:01590-2726
Mailing Address - Country:US
Mailing Address - Phone:508-341-6429
Mailing Address - Fax:
Practice Address - Street 1:41 MCGUIRE RD
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:MA
Practice Address - Zip Code:01590-2726
Practice Address - Country:US
Practice Address - Phone:508-341-6429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health