Individual
MRS. CARRIE MARIE BRADSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS/CCC-SLP
Contact information
Practice address
29294 390TH ST, GRIGGSVILLE, IL 62340-2273
(217) 430-3410
Mailing address
29294 390TH ST, GRIGGSVILLE, IL 62340-2273
(217) 430-3410
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146010674
IL
Other
Enumeration date
02/12/2014
Last updated
02/12/2014
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