Individual
MR. BRAD TRAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS.CADC
Contact information
Practice address
1224 NORLEY AVE, JOLIET, IL 60435-4074
(815) 690-0213
(815) 846-0436
Mailing address
PO BOX 153, JOLIET, IL 60434-0153
(815) 690-0213
(815) 846-0436
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14173
IL
Other
Enumeration date
10/11/2011
Last updated
10/11/2011
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