Individual
BRADLEY SHOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
593 NW YORK DR STE 150, BEND, OR 97703-7265
(541) 678-3268
Mailing address
593 NW YORK DR STE 150, BEND, OR 97703-7265
(541) 678-3268
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C6292
OR
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
07/06/2018
Last updated
12/04/2024
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