Individual
BRADLEY THOMAS BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2403 PROFESSIONAL CENTER DR, SANTA ROSA, CA 95403
(707) 360-4552
Mailing address
15002 CHALK HILL RD, HEALDSBURG, CA 95448-9027
(707) 955-0243
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/01/2025
Last updated
07/01/2025
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