Provider Demographics
NPI:1801984083
Name:ALDRICH, BRADLEY K (LMFT)
Entity type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:K
Last Name:ALDRICH
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 NEWPORT PIKE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GAP
Mailing Address - State:PA
Mailing Address - Zip Code:17527-9579
Mailing Address - Country:US
Mailing Address - Phone:717-442-9577
Mailing Address - Fax:717-442-9675
Practice Address - Street 1:91 NEWPORT PIKE
Practice Address - Street 2:SUITE 102
Practice Address - City:GAP
Practice Address - State:PA
Practice Address - Zip Code:17527-9579
Practice Address - Country:US
Practice Address - Phone:717-442-9577
Practice Address - Fax:717-442-9675
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000439106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist