Individual
SHANNON DEIRDRE BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5502 MARVIN SHIELDS BLVD, GULFPORT, MS 39501
(228) 822-5710
Mailing address
5502 MARVIN SHIELDS BLVD, GULFPORT, MS 39501
(282) 822-5710
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW 13312
FL
Other
Enumeration date
08/08/2014
Last updated
04/22/2022
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