Individual
BRAD JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4600 3RD ST, MOLINE, IL 61265-6106
(309) 779-3000
Mailing address
344 14TH AVE, MOLINE, IL 61265-2924
(309) 781-2192
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
04/13/2021
Last updated
04/13/2021
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