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General NPI Number Information
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NPI Number | 1285942797
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Entity Type | Individual
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Provider Name | BRADLEY BYCHINSKI L.M.F.T
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Gender | Male
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Dates
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Enumeration Date | 09/17/2010
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Last Update Date | 02/17/2023
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Provider Practice Location Address
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Address Line | 1664 CLIFF RD E
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City | BURNSVILLE
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State | MN
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Zip | 55337-1300
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Country | US
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Telephone | 612-390-5070
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Fax |
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Provider Business Mailing Address
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Address Line | 11986 PORTLAND AVE
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City | BURNSVILLE
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State | MN
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Zip | 55337-1516
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Country | US
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Telephone | 612-390-5070
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1839
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License Number State | MN
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