BRADLEY THOMAS BLACKWELL

SANTA ROSA, CA
NPI1801785001
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2025-07-01
Last Update Date2025-07-01
Business Address
BRADLEY THOMAS BLACKWELL
2403 PROFESSIONAL CENTER DR
SANTA ROSA, CA 95403
Phone number: 707-360-4552
Mailing Address
BRADLEY THOMAS BLACKWELL
15002 CHALK HILL RD
HEALDSBURG, CA 95448-9027
Phone number: 707-955-0243
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