Individual
J. BRADLEY HOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
495 E MAIN ST, COLUMBUS, OH 43215-5349
(614) 355-8695
(614) 355-8620
Mailing address
DEPT 781625, DETROIT, MI 48278-1625
(614) 355-8004
(614) 355-2220
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
C.1300440
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2846675
—
OH
Enumeration date
08/30/2013
Last updated
02/16/2016
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