Provider Demographics
NPI:1508898735
Name:KNAPP, BRADLEY WILLIAM (MS PSYCHOTHERAPIST)
Entity Type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:WILLIAM
Last Name:KNAPP
Suffix:
Gender:M
Credentials:MS PSYCHOTHERAPIST
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:17 S RIVER
Mailing Address - Street 2:STE 254
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548
Mailing Address - Country:US
Mailing Address - Phone:608-755-5260
Mailing Address - Fax:608-755-5267
Practice Address - Street 1:17 S RIVER
Practice Address - Street 2:STE 254
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548
Practice Address - Country:US
Practice Address - Phone:608-755-5260
Practice Address - Fax:608-755-5267
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor