Bradley, Tyeisha R

Bradley, Tyeisha R is an individual health care provider with primary practice located at 650 Joel Dr , Fort Campbell KY 42223-5318. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Bradley, Tyeisha R can be contacted via phone (270) 798-8400.

Contact Information

Primary practice address
650 Joel Dr Fort Campbell KY 42223-5318
Phone: (270) 798-8400
Fax: (270) 798-8224
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X Illinois
Behavioral Health & Social Service Providers / Clinical 1041C0700X LCSW-4317 Hawaii

Profile Details

NPI number 1144571977
LBN Legal business name Bradley, Tyeisha R
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 19th, 2012
Last updated Jun 28th, 2024 - about 5 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers