| Doctor Name: | DR. JAMES ROBERT BRADY |
| NPI Number: | 1023107984 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | PC000292 |
| Business Practice Address: | 105 Lakemont Blvd. Altoona, PA - 16602 |
| Business Phone Number: | 8149429999 |
| Business Fax Number: | 8149429999 |
| Mailing Address: | Rr 1 Box 76, MARTINSBURG |
| State: | PA |
| Postal Code: | 166629608 |
| Phone Number: | 8149429999 |
| Fax Number: | 8149429999 |
| NPI Enumeration Date: | 10/11/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | PC000292 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |