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Individual

BRADI FRITTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1100 NW 12TH ST, FRUITLAND, ID 83619-5040
(208) 739-6248
(541) 216-6557
Mailing address
1100 NW 12TH ST, FRUITLAND, ID 83619-5040
(208) 452-6556
(541) 216-6557

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
LCSW-37109
ID
1041C0700X
Clinical Social Worker
Primary
L5068
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
804398400
ID
Enumeration date
02/24/2011
Last updated
10/24/2023
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