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1235561093
BRADLEY JOLINE ANTONIDES
FORT POLK, LA
NPI
1235561093
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: WA PY60633804)
Enumeration Date
2013-08-04
Last Update Date
2017-02-21
Business Address
-- BRADLEY JOLINE ANTONIDES M.S.
1585 3RD ST
FORT POLK, LA 71459-5102
Phone number: 337-531-6140
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Mailing Address
-- BRADLEY JOLINE ANTONIDES M.S.
1585 3RD ST
FORT POLK, LA 71459-5102
Phone number:
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