Individual
BRADLEY SUMMERS-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2817 ROCK MERRITT AVE, FORT LIBERTY, NC 28310-2697
(910) 907-8922
(910) 907-6069
Mailing address
11022 DEAN CT SW, LAKEWOOD, WA 98498-3732
(503) 801-9259
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY60981886
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/13/2016
Last updated
01/29/2025
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