Bradley, Brian William

Bradley, Brian William is an sole proprietor health care provider with primary practice located at 101 Falls Rd Suite 404, Grafton WI 53024-2612. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Bradley, Brian William can be contacted via phone (262) 375-8441.

Contact Information

Primary practice address
101 Falls Rd Suite 404 Grafton WI 53024-2612
Phone: (262) 375-8441
Fax: (262) 546-0005
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 868 Wisconsin

Profile Details

NPI number 1740347608
LBN Legal business name Bradley, Brian William
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 2nd, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1740347608 NPPES
Wisconsin Other 868 PSYCHOLOGY LICENSE NUMBER
Wisconsin MEDICAID 39050200 PSYCHOLOGY LICENSE NUMBER

Popular Providers