Individual
BRADLEY SHIPLEY SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
304 WELLINGTON PL, JACKSONVILLE, NC 28546-8341
(910) 939-9986
Mailing address
304 WELLINGTON PL, JACKSONVILLE, NC 28546-8341
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
904867
NC
Other
Enumeration date
03/13/2023
Last updated
03/13/2023
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