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Individual
BRADLEY ROSS
Active
Individual
BRADLEY ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5165-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154665214
—
WI
Enumeration date
11/15/2012
Last updated
02/24/2025
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