Individual
BRADLEY ADAIR VATTILANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LMHC
Contact information
Practice address
22904 LYDEN DR UNIT 104, ESTERO, FL 33928-7048
(239) 494-3951
(239) 217-9561
Mailing address
22904 LYDEN DR UNIT 104, ESTERO, FL 33928-7048
(239) 494-3951
(239) 217-9561
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH21446
FL
Other
Enumeration date
07/16/2019
Last updated
01/05/2024
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