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Individual
BRADLEY BUCKELEW
Active
Individual
BRADLEY BUCKELEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA-01161
IA
103K00000X
Behavior Analyst
LBA0316
MN
Other
Enumeration date
11/01/2017
Last updated
12/04/2025
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