| NPI | 1174851455 |
|---|---|
| Professional Name | BRADLEY ROARK |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 72022) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MO 2009000984) |
| 101YP2500X Counselor, Professional (Licence: MO 2009000984) | |
| Enumeration Date | 2009-11-25 |
| Last Update Date | 2024-10-13 |