Individual
MR. BRADLEY JACK BEATTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICDC-CS
Contact information
Practice address
3767 RICHARD AVE, GROVE CITY, OH 43123-2417
(614) 877-2441
Mailing address
3767 RICHARD AVE, GROVE CITY, OH 43123-2417
(614) 877-2441
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
910395
OH
Other
Enumeration date
09/03/2014
Last updated
09/03/2014
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