Bradley Wallace, LMFT

NPI 1215706528 · on the registry since 2023

Practice

Address: 1145 Volunteer Pkwy
Bristol, TN 37620
Phone: (423) 989-4500
Fax: (423) 989-4582
Organisation at this address: Frontier Health
Genoa Healthcare Llc
Michelle Marie Moncier
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 11

Registry record

Primary taxonomy: 106H00000X
106H00000X
Licence states on file: TN
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2025-03-04

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Tennessee