Individual
SHARI LYNN BRADSTREAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCDC III
Contact information
Practice address
1101 E PHILADELPHIA ST, RAPID CITY, SD 57701-1731
(605) 343-1620
(605) 343-1629
Mailing address
1101 E PHILADELPHIA ST, RAPID CITY, SD 57701-1731
(605) 343-1620
(605) 343-1629
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
07121348
SD
Other
Enumeration date
05/12/2011
Last updated
05/12/2011
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