| Doctor Name: | MR. BRADLEY TODD KINDER |
| NPI Number: | 1154658854 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC, CSAC |
| License Number: | 0701004720 |
| Business Practice Address: | 1100 Cedar Valley Drive Suite 3 Cedar Bluff, VA - 24609 |
| Business Phone Number: | 2769630111 |
| Business Fax Number: | 2769630005 |
| Mailing Address: | Po Box 426, CEDAR BLUFF |
| State: | VA |
| Postal Code: | 246090426 |
| Phone Number: | 2769630111 |
| Fax Number: | 2769630005 |
| NPI Enumeration Date: | 11/17/2009 |
| NPI Last Update Date: | 06/28/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 0701004720 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |