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Individual

KENNETH J BRADY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LADC I,CADAC II

Contact information

Practice address
30 GUILD ST, MEDFORD, MA 02155-1207
(617) 633-1851
Mailing address
30 GUILD ST, MEDFORD, MA 02155-1207
(617) 633-1851

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
MA

Other

Enumeration date
04/05/2011
Last updated
04/05/2011
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