Individual
THERESA BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
401 E CHESTNUT ST, SUITE 510, LOUISVILLE, KY 40202-5700
(502) 589-0802
(502) 589-0805
Mailing address
401 E CHESTNUT ST, SUITE 510, LOUISVILLE, KY 40202-5700
(502) 589-0802
(502) 589-0805
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
KY-R2889
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KY-R2889
LICENSE
KY
Enumeration date
10/17/2008
Last updated
10/17/2008
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