Individual
WILLIAM DALE BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA,LISAC
Contact information
Practice address
483 WEST SEEDFARM ROAD, SACATON, AZ 85247-0038
(602) 528-3321
(602) 528-1374
Mailing address
483 WEST SEEDFARM ROAD, SACATON, AZ 85247-0038
(602) 528-3321
(602) 528-1374
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-10982
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
346214
—
AZ
Enumeration date
02/05/2008
Last updated
02/05/2008
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