Individual
MS. LISA BRADWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1540 SPRING VALLEY DR, MAIL STOP 581-122, HUNTINGTON, WV 25704-9300
(304) 429-6741
Mailing address
1540 SPRING VALLEY DR, MAIL STOP 581-122, HUNTINGTON, WV 25704-9300
(304) 429-6741
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CP00942698
WV
Other
Enumeration date
10/02/2009
Last updated
10/02/2009
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