Individual
MR. BRADLEY DALE MARINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
12701 TOWNEPARK WAY, BARKLEY BLDG. STE 200, LOUISVILLE, KY 40243-2384
(502) 254-8880
(502) 254-8870
Mailing address
12701 TOWNEPARK WAY, BARKLEY BLDG. STE 200, LOUISVILLE, KY 40243-2384
(502) 254-8880
(502) 254-8870
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPCPCC00218860
KY
Other
Enumeration date
06/09/2015
Last updated
06/09/2015
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