Individual
MR. BRADLEY ALLEN SANSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, CADC
Contact information
Practice address
628 JEFFERSON AVE, PAINTSVILLE, KY 41240-1471
(606) 789-6966
(606) 789-7466
Mailing address
628 JEFFERSON AVE, PAINTSVILLE, KY 41240-1471
(606) 789-6966
(606) 789-7466
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
244702
KY
Other
Enumeration date
08/10/2020
Last updated
04/04/2022
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