Individual
MR. BRADLEY EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
634 WYMOUNT TER, PROVO, UT 84604-2028
(801) 378-6023
Mailing address
634 WYMOUNT TER, PROVO, UT 84604-2028
(801) 378-6023
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/24/2006
Last updated
07/08/2007
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