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NPI Code Detail

MEDICARE: BRADLEY EDWARD SIMONS I RTB

MEDICARE: BRADLEY EDWARD SIMONS I RTB
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianBACB1300551NV

General Provider Information

NPI Number : 1710796032
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRADLEY EDWARD SIMONS I RTB
Provider Business Mailing Address
First Line : 3785 BAKER LN
Second Line :
City : RENO
State : NV
Zip : 89509-5453
Country : US
Telephone Number : 775-391-9226
Fax Number :
Provider Business Practice Location Address
First Line : 3785 BAKER LN
Second Line :
City : RENO
State : NV
Zip : 89509-5453
Country : US
Telephone Number : 775-560-4825
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/01/2025
Last Update Date : 02/11/2026

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Directions to “ BRADLEY EDWARD SIMONS I RTB” Practice Location

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