Individual
BRAD TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16248 VICTOR ST, VICTORVILLE, CA 92395-3934
(760) 243-7151
(760) 952-1432
Mailing address
16248 VICTOR ST, VICTORVILLE, CA 92395-3934
(760) 243-7151
(760) 952-1432
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1223870316
CA
Other
Enumeration date
03/07/2016
Last updated
03/07/2016
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