| Doctor Name: | BRAD GUY |
| NPI Number: | 1134594104 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 21125150 |
| Business Practice Address: | 280 Foliage Ln Springboro, OH - 450669314 |
| Business Phone Number: | 5133348189 |
| Business Fax Number: | |
| Mailing Address: | 280 Foliage Ln, SPRINGBORO |
| State: | OH |
| Postal Code: | 450669314 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 12/02/2015 |
| NPI Last Update Date: | 12/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | 21125150 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |