Individual
BRADLEY W. BASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
322 S LAURA AVE, WICHITA, KS 67211-1517
(316) 789-4193
Mailing address
322 S LAURA AVE, WICHITA, KS 67211-1517
(316) 789-4193
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1129
KS
Other
Enumeration date
05/01/2006
Last updated
12/09/2024
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