Individual
MR. BRADLEY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PCCI
Contact information
Practice address
8420 FORDHAM RD, APT 2, LOS ANGELES, CA 90045-2581
(310) 704-3482
Mailing address
8420 FORDHAM RD, APT 2, LOS ANGELES, CA 90045-2581
(310) 704-3482
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PCCI12756
CA
Other
Enumeration date
06/28/2016
Last updated
06/28/2016
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