| Doctor Name: | BRADLEY A ROWE |
| NPI Number: | 1073856191 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LADC |
| License Number: | 890 |
| Business Practice Address: | 917 W 21st St South Sioux City, NE - 687762652 |
| Business Phone Number: | 4024943337 |
| Business Fax Number: | |
| Mailing Address: | 1651 W Polk Ave, CHARLESTON |
| State: | IL |
| Postal Code: | 619207600 |
| Phone Number: | 4023408766 |
| Fax Number: | |
| NPI Enumeration Date: | 03/27/2013 |
| NPI Last Update Date: | 03/27/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 890 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |