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Individual

MRS. STEPHANIE JENE' (SMITH) BRADSHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
1102 W 32ND ST, JOPLIN, MO 64804-3503
(417) 347-6616
Mailing address
402 ANGEL LEA, CARL JUNCTION, MO 64834-9329
(417) 649-6383

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2008017253
MO

Other

Enumeration date
07/25/2008
Last updated
07/25/2008
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