Individual
ANDREW BRADLYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
930 CHESTNUT RIDGE RD, MORGANTOWN, WV 26505-2807
(304) 598-4214
Mailing address
PO BOX 897, MORGANTOWN, WV 26507-0897
(304) 293-7401
(304) 293-6963
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
405
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0162916000
—
WV
Enumeration date
02/14/2006
Last updated
11/05/2008
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