Individual
BRADLEY PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
340 E 100 S, SALT LAKE CITY, UT 84111-1702
(801) 322-3222
Mailing address
11651 MAPLEBERRY CT, DRAPER, UT 84020-6858
(801) 599-2405
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/16/2010
Last updated
09/16/2010
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