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Individual

MICHAEL W. BRADBURN

Active
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Individual

MICHAEL W. BRADBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
149.008325
IL
106H00000X
Marriage & Family Therapist
—
—

Other

Enumeration date
08/06/2010
Last updated
08/01/2013
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