Individual
MRS. STALEY BRADBURN JUSTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
4800 MEMORIAL DR, 151W, WACO, TX 76711-1329
(254) 297-3951
(254) 297-3562
Mailing address
521 KRISTI ST, ROBINSON, TX 76706-5120
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
52624
TX
Other
Enumeration date
11/24/2010
Last updated
11/24/2010
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