Bradley Phillip Bogdan, MSW
Social Worker, Clinical in Bryan, TX. Individual provider (NPI-1).
NPI number1487907366
StatusActive
Last updated in NPPESJul 15, 2020
Details
- NPI
- 1487907366
- Entity type
- Individual (NPI-1)
- Name
- Bradley Phillip Bogdan
- Credential
- MSW
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 17, 2012
- Certification date
- Jul 15, 2020
- Last updated
- Jul 15, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
| 104100000X | Social Worker | – | – |
Practice location
8441 State Highway 47 Ste 1400Bryan, TX 77807-3208
Phone 979-776-8440 · Fax 877-601-5854
Mailing address
2900 E 29th St Ste 100Bryan, TX 77802-2623
Phone 979-436-0483 · Fax 877-601-5854
Other practice locations
109 4th St
Eureka, CA 95501-0325
Eureka, CA 95501-0325
Phone 707-442-4322 · Fax 707-442-4113
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