Individual
BRADLEY WALLACE SHEPPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSW LLBSW
Contact information
Practice address
2222 S M 30, WEST BRANCH, MI 48661-8711
(989) 345-5571
(989) 345-4111
Mailing address
PO BOX 310, TAWAS CITY, MI 48764-0310
(989) 362-8636
(989) 345-4111
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802088639
MI
Other
Enumeration date
08/16/2018
Last updated
08/16/2018
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