Individual
MR. BRADLEY JAMES ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
114 KARADAN DR, MAHOMET, IL 61853-3641
(217) 840-2520
Mailing address
114 KARADAN DR, MAHOMET, IL 61853-3641
(217) 840-2520
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149-005946
IL
Other
Enumeration date
06/08/2007
Last updated
09/26/2012
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