Bradley S Wallace, LMFT

NPI #1215706528 in Bristol, Tennessee

Provider Information

NPI Number: 1215706528
Entity Type: Individual
Name: Bradley S Wallace, LMFT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Marriage & Family Therapist
Credential: LMFT
Enumeration Date: Dec 28, 2023
Last Updated: Mar 4, 2025

Practice Location

Address: 1145 VOLUNTEER PKWY
City: Bristol
State: Tennessee
ZIP Code: 37620-4652
Phone: (423) 989-4500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Marriage & Family Therapist	106H00000X	Primary

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