Individual
BRADLEY SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3708 ROBINWOOD CIR, BRYANT, AR 72022-8374
(501) 993-5465
Mailing address
3708 ROBINWOOD CIR, BRYANT, AR 72022-8374
(501) 993-5465
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P0002005
AR
Other
Enumeration date
10/08/2014
Last updated
10/08/2014
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