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DR. BRADLEY WILLIAM PATTERSON PHD

Clinical Neuropsychologist

Pueblo, Colorado

Provider NPI: 1053376392

Provider Information:
DR. BRADLEY WILLIAM PATTERSON PHD
Gender: M
Not Sole Proprietor

Practice Location:
516 W 14TH ST  PUEBLO, CO 81003 US
Tel: 719-545-4983  Fax: --

Business Mailing Address:
516 W 14TH ST  PUEBLO, CO 81003 US
Tel: 719-545-0822  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
CO1375

Other Provider Identifiers:

IssuerNumberStateType
R18896CO02
C82916CO08
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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