Individual
BRADLEY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
10 6TH AVE W, HUNTINGTON, WV 25701-0028
(304) 525-8014
Mailing address
10 6TH AVE W, HUNTINGTON, WV 25701-0028
(304) 525-8014
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-111802
WV
Other
Enumeration date
02/06/2020
Last updated
02/06/2020
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