Individual
MIJA BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDP
Contact information
Practice address
3925 8TH AVE SE STE A, LACEY, WA 98503-1122
(360) 923-9585
(888) 310-1691
Mailing address
3925 8TH AVE SE STE A, LACEY, WA 98503-1122
(360) 923-9585
(888) 310-1691
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
00003745
WA
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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