| Doctor Name: | BRADLEY JOSEPH OSBORN |
| NPI Number: | 1457604266 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CACIII |
| License Number: | 6654 |
| Business Practice Address: | 405 Castle Creek Rd Suite 9 Aspen, CO - 816113125 |
| Business Phone Number: | 9709205555 |
| Business Fax Number: | 9709205557 |
| Mailing Address: | 515 28 3/4 Rd, GRAND JUNCTION |
| State: | CO |
| Postal Code: | 815015016 |
| Phone Number: | 9702416023 |
| Fax Number: | 9702553963 |
| NPI Enumeration Date: | 10/17/2012 |
| NPI Last Update Date: | 10/17/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 6654 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |