Individual
BRADLEY JERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
282 WASHINGTON ST, HARTFORD, CT 06106-3322
(860) 545-9507
(860) 545-9561
Mailing address
100 RETREAT AVE, HARTFORD HOSPITAL CHILD PSYCHIATRY, DIV OF PSYCHOLOGY, HARTFORD, CT 06106-2528
(860) 837-5206
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
003501
CT
103TC0700X
Clinical Psychologist
Primary
003501
CT
103TC2200X
Clinical Child & Adolescent Psychologist
003501
CT
Other
Enumeration date
03/27/2014
Last updated
09/09/2022
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