Individual
BRADI GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
215 W NORTH 9TH ST, SHELBYVILLE, IL 62565-1015
(765) 404-4002
Mailing address
215 W NORTH 9TH ST, SHELBYVILLE, IL 62565-1015
(765) 404-4002
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178.015680
IL
101YP2500X
Professional Counselor
Primary
180.015047
IL
Other
Enumeration date
01/28/2020
Last updated
02/28/2023
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