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Individual
SHIRLEY R BRADLEY I
Active
Individual
SHIRLEY R BRADLEY I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
1413
CT
1041C0700X
Clinical Social Worker
11193
CT
1041C0700X
Clinical Social Worker
Primary
17396
SC
Other
Enumeration date
02/12/2018
Last updated
12/16/2024
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