Individual
MRS. TASHIKO LYNN BRADSHAW BROADHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
100 EMANCIPATION DR, HAMPTON, VA 23667-0001
(757) 722-9961
Mailing address
PO BOX 1344, NEWPORT NEWS, VA 23601-0344
(757) 722-9961
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW0000008851
TN
Other
Enumeration date
01/17/2013
Last updated
01/17/2013
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