Individual
ANGELA R. BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCD,CCC-SLP
Contact information
Practice address
1298 HILLCREST DR, PIGGOTT, AR 72454-3121
(870) 598-3049
Mailing address
1298 HILLCREST DR, PIGGOTT, AR 72454-3121
(870) 598-3049
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SP1632
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5W969
BLUECROSS BLUE SHIELD
AR
Enumeration date
04/02/2006
Last updated
07/09/2007
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