Individual
BRIAN K BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AII2201214
Contact information
Practice address
2212 N WINERY AVE, FRESNO, CA 93703-2896
(559) 600-9168
Mailing address
515 S CEDAR AVE, FRESNO, CA 93702-2908
(559) 600-9168
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
AII2201214
CA
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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