Individual
TENILLE BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
203 SANTA CLAUS LN, NORTH POLE, AK 99705-6055
(765) 432-9697
Mailing address
439 E 8TH AVE, NORTH POLE, AK 99705-7665
(765) 432-9697
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/11/2017
Last updated
12/11/2017
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