Provider Demographics
NPI:1679378186
Name:BRADLEY, ALEXA C
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:C
Last Name:BRADLEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46747 HOBBLEBUSH TER
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20164-7021
Mailing Address - Country:US
Mailing Address - Phone:571-449-1277
Mailing Address - Fax:
Practice Address - Street 1:9970 ST. LOUIS RD.
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132
Practice Address - Country:US
Practice Address - Phone:703-576-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty