Individual
DR. BRADLEY ANDREW GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
618 WELLINGTON ST, TYLER, TX 75703-4663
(601) 297-6591
Mailing address
618 WELLINGTON ST, TYLER, TX 75703-4663
(601) 297-6591
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
39019
TX
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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