Individual
MEDEA ELIZABETH BRADBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LSCSW
Contact information
Practice address
1213 R D MIZE RD APT A, GRAIN VALLEY, MO 64029-9462
(573) 999-2733
Mailing address
1213 R D MIZE RD APT A, GRAIN VALLEY, MO 64029-9462
(573) 999-2733
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2019035423
MO
1041C0700X
Clinical Social Worker
5214
KS
Other
Enumeration date
09/24/2020
Last updated
09/24/2020
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