Individual
MR. BRADLEY CARLYLE GOBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA LCPC
Contact information
Practice address
313 N MATTIS AVE, CHAMPAIGN, IL 61821-2460
(217) 348-1086
(217) 355-4012
Mailing address
1004 10TH ST, CHARLESTON, IL 61920-2822
(217) 348-1354
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
IL
Other
Enumeration date
03/10/2007
Last updated
07/08/2007
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