Individual
BRADLEY ALLEN FERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
1320 S FRONTAGE RD, HASTINGS, MN 55033-2684
(651) 500-1466
Mailing address
3933 EWING AVE S, MINNEAPOLIS, MN 55410-1053
(612) 226-6897
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1562
MN
Other
Enumeration date
07/12/2013
Last updated
07/12/2013
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