Individual
BROOKE MICHAEL BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
S.S.W.
Contact information
Practice address
474 W 200 N, ST GEORGE, UT 84770-4505
(435) 634-5660
Mailing address
1630 E 2450 S, 31, SAINT GEORGE, UT 84790-6228
(435) 632-5791
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6111186-3503
UT
Other
Enumeration date
11/28/2012
Last updated
11/28/2012
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