Individual
BRADLEY MARVIN HEAD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
2550 SHOW LOW LAKE ROAD, SHOW LOW, AZ 85901-7929
(928) 537-1029
(928) 537-9049
Mailing address
2550 SHOW LOW LAKE ROAD, SHOW LOW, AZ 85901-7929
(928) 537-1029
(928) 537-9049
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC0637
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
742488
AHCCCS
AZ
Enumeration date
04/20/2006
Last updated
07/08/2007
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