Individual provider · Type 1 NPI

Bradley G. Wise, LICDC-CS

Addiction (Substance Use Disorder) Counselor · Mansfield, OH

NPI number 1194139980 Active

Practice location

1150 N Main St
Mansfield, OH 44903-9718

Call (419) 526-2000 Map

Fax (419) 524-8022

Mailing address

PO Box 788
Mansfield, OH 44901-0788

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X954172 (OH)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1194139980

Bradley G. Wise, LICDC-CS's National Provider Identifier is 1194139980, issued on Jun 19, 2014. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Mansfield, OH. The record was last updated on Jun 19, 2014.