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1194578716
BRADLEY LAWRENCE AUSTIN
SHELTON, WA
NPI
1194578716
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA C061511120)
Enumeration Date
2024-04-11
Last Update Date
2024-04-11
Business Address
BRADLEY LAWRENCE AUSTIN SUDPT
235 S 3RD ST
SHELTON, WA 98584-2255
Phone number: 360-426-0890
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Mailing Address
BRADLEY LAWRENCE AUSTIN SUDPT
1024 PROSPECT AVE NE APT 8
OLYMPIA, WA 98506-4079
Phone number: 360-972-4604
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