Individual
MR. BRIAN DAVID BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
30200 TELEGRAPH RD, SUITE 207, BINGHAM FARMS, MI 48025-4502
(248) 712-1129
(248) 569-9410
Mailing address
4217 ARLINGTON DR, ROYAL OAK, MI 48073-6305
(248) 761-9679
(248) 569-9410
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301006993
MI
103TS0200X
School Psychologist
CC-0C3110345997
MI
Other
Enumeration date
07/20/2014
Last updated
08/09/2014
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