Basic Information
| Provider Information | |||||||||
| NPI: | 1871840553 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRADFORD | ||||||||
| FirstName: | ADAM | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSYD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 975 KIRMAN AVE | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895020993 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757867200 | ||||||||
| FaxNumber: | 7753265750 | ||||||||
| Practice Location | |||||||||
| Address1: | 975 KIRMAN AVE | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895020993 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757867200 | ||||||||
| FaxNumber: | 7753265750 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2012 | ||||||||
| LastUpdateDate: | 07/07/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 021656 | NY | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.