Individual
BRADLEY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 VETERANS DR, MINNEAPOLIS, MN 55417-2309
(612) 467-2325
Mailing address
30435 WALLMARK LAKE DR, CHISAGO CITY, MN 55013-9586
(651) 257-3993
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
303536
MN
1041C0700X
Clinical Social Worker
Primary
24534
MN
Other
Enumeration date
02/09/2016
Last updated
02/09/2016
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