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1619601101
WILLIAM BRADFORD ELLIS
TROY, NY
NPI
1619601101
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: NY 35967)
Enumeration Date
2022-07-12
Last Update Date
2022-11-28
Business Address
WILLIAM BRADFORD ELLIS CASAC
2435 6TH AVE
TROY, NY 12180-2227
Phone number: 518-274-5143
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Mailing Address
WILLIAM BRADFORD ELLIS CASAC
12 THE MALL ST
AMSTERDAM, NY 12010-1224
Phone number:
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