Individual
KATHY ANNA BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
730 S DARGAN ST, FLORENCE, SC 29506-2563
(843) 661-4718
Mailing address
125 EAST CHEVES STREET, FLORENCE, SC 29506-2526
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376241
—
SC
Enumeration date
04/03/2007
Last updated
07/08/2007
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