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1477087625
BRADLEY NELSON RUSSELL
EL CAJON, CA
NPI
1477087625
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-04-14
Last Update Date
2017-04-14
Business Address
-- BRADLEY NELSON RUSSELL
1364 JOHNSON AVE. SUITE 111
EL CAJON, CA 92020
Phone number: 619-440-4801
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Mailing Address
-- BRADLEY NELSON RUSSELL
1400 N JOHNSON AVE
EL CAJON, CA 92020-1650
Phone number: 619-440-4801
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