Organization
AHIMSA CENTER FOR GROWTH AND DEVELOPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY BRADLEY LICSW (OWNER)
(617) 698-0998
Entity
Organization
Contact information
Practice address
464 GRANITE AVE, SUITE 25, MILTON, MA 02186-5625
(617) 698-0991
(617) 698-1274
Mailing address
464 GRANITE AVE, SUITE 25, MILTON, MA 02186-5625
(617) 698-0991
(617) 698-1274
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
2084P0800X
Psychiatry Physician
46623
MA
Other
Enumeration date
05/19/2008
Last updated
05/19/2008
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