Individual
JOHN BRADLEY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PCC
Contact information
Practice address
6825 N STATE ROUTE 66, DEFIANCE, OH 43512-6730
(419) 782-4196
Mailing address
PO BOX 8970, TOLEDO, OH 43623-0970
(419) 782-4196
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E0003984
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366526782
—
OH
Enumeration date
08/19/2006
Last updated
05/05/2015
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