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Individual

PROF. REMONE TERRELL BRADLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2436 W ROESER RD, PHOENIX, AZ 85041-3601
(202) 779-7018
Mailing address
2436 W ROESER RD, PHOENIX, AZ 85041-3601
(202) 779-7018

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
84-3078191
ACCHS
AZ
Enumeration date
12/08/2022
Last updated
12/08/2022
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