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General NPI Number Information
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NPI Number | 1457244550
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Entity Type | Individual
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Provider Name | BRADLEY WOODS
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Gender | Male
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 2675 BECHELLI LN STE 11
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City | REDDING
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State | CA
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Zip | 96002-1955
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Country | US
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Telephone | 530-232-0845
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Fax |
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Provider Business Mailing Address
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Address Line | 4809 MAIN ST
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City | SHASTA LAKE
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State | CA
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Zip | 96019-9746
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Country | US
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Telephone | 530-356-3025
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-25-81458
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License Number State | CA
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