Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | MH10473 | FL |
Y | 101YM0800X | Mental Health Counselor | MH10473 | FL |
N | 101YP1600X | Pastoral Counselor | MH10473 | FL |
N | 101YP2500X | Professional Counselor | APA 12141 | FL |
NPI | 1184935314 |
---|---|
Provider Name | Ms. Bradley Jean Van Hoek |
First Address | Palm Beach, FL 33480-4606 |
Second Address | Palm Beach, FL 33480-4606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2010 |
Last Update Date | 12/09/2011 |