Individual
DR. LONNIE BRADFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
3812 8TH ST N STE 200, SAINT CLOUD, MN 56303-1421
(513) 612-0876
Mailing address
3812 8TH ST N STE 200, SAINT CLOUD, MN 56303-1421
(513) 612-0876
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
6007
MN
103TC0700X
Clinical Psychologist
1673
AL
Other
Enumeration date
10/15/2009
Last updated
11/22/2019
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