Doctor Name: | MR. RONALD BRYAN TREADWAY |
NPI Number: | 1013109826 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 54279 |
Business Practice Address: | 572 N Arrowhead Ave San Bernardino, CA - 924011251 |
Business Phone Number: | 9092662700 |
Business Fax Number: | 9092662791 |
Mailing Address: | 572 N Arrowhead Ave, SAN BERNARDINO |
State: | CA |
Postal Code: | 924011251 |
Phone Number: | 9092662700 |
Fax Number: | 9092662791 |
NPI Enumeration Date: | 08/15/2007 |
NPI Last Update Date: | 08/24/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 54279 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |