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Individual

BRADLEY WILLIAM ROTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
57 CRESTWOOD RD, MILFORD, CT 06460-6923
(203) 888-0462
(203) 888-1465
Mailing address
57 CRESTWOOD RD, MILFORD, CT 06460-6923
(203) 877-3600

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
27.002034
CT
106H00000X
Marriage & Family Therapist
Primary
27.002034
CT

Other

Enumeration date
11/26/2018
Last updated
09/22/2023
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