Individual
BRADLEY CHARLES SUBLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
102 COUNTRY CLUB PKWY, MAUMELLE, AR 72113-6705
(501) 628-9066
Mailing address
32 BELLE RIVER CV, MAUMELLE, AR 72113-7024
(501) 352-2429
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6904-C
AR
Other
Enumeration date
07/16/2013
Last updated
08/29/2016
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