Individual
RANDY E BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSCSW
Contact information
Practice address
550 POPE AVE, ATTN: CREDENTIALS, FORT LEAVENWORTH, KS 66027-2332
(913) 684-6562
Mailing address
550 POPE AVE, FORT LEAVENWORTH, KS 66027-2332
(913) 758-9884
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
4238
KS
1041C0700X
Clinical Social Worker
Primary
4238
KS
Other
Enumeration date
12/20/2010
Last updated
01/04/2024
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