Individual
MR. LEONARD EUGENE BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSE, CCDP-D, ICCDP-D
Contact information
Practice address
9167 W FLORISSANT AVE, SAINT LOUIS, MO 63136-1420
(314) 547-4081
(314) 524-3804
Mailing address
PO BOX 703, BRIDGETON, MO 63044-0703
(314) 574-4081
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4917
MO
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
07/31/2006
Last updated
09/02/2010
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