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1194139980
BRADLEY G. WISE
MANSFIELD, OH
NPI
1194139980
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: OH 954172)
Enumeration Date
2014-06-19
Last Update Date
2014-06-19
Business Address
BRADLEY G. WISE LICDC-CS
1150 N MAIN ST
MANSFIELD, OH 44903-9718
Phone number: 419-526-2000
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Mailing Address
BRADLEY G. WISE LICDC-CS
PO BOX 788
MANSFIELD, OH 44901-0788
Phone number: 419-526-2000
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