Individual
BILL MACK BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
629 OAKLAND AVE, OAKLAND, CA 94611-4567
(510) 850-7283
Mailing address
629 OAKLAND AVE, OAKLAND, CA 94611-4567
(510) 850-7283
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
CA
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/03/2019
Last updated
01/03/2019
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