SearchVirginia1041C0700X

Kevin Bradley, LCSW

NPI 1184192981 · on the registry since 2018 · sole proprietor

Practice

Address
12408 Alexander Cornell Dr
Fairfax, VA 22033
Phone
(703) 658-9054

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Licence states on file
VA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2018-11-09

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia