Individual
BRADLEY LAWRENCE MALLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
4740 FLINTRIDGE DR STE 214, COLORADO SPRINGS, CO 80918-4273
(719) 357-5546
Mailing address
220 RUSKIN DR, COLORADO SPRINGS, CO 80910-2522
(719) 572-6100
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC.0013536
CO
Other
Enumeration date
06/02/2011
Last updated
02/05/2025
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