Individual
WILLIAM MICHEAL BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
1607 W 32ND ST, PUEBLO, CO 81008-1313
(719) 565-8829
Mailing address
131 EAGLE CREST LOOP, CANON CITY, CO 81212-9698
(719) 565-8829
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACD0002279
CO
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
10/22/2019
Last updated
11/14/2023
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