Individual
SHALAKO BRADBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
1350 HILLRISE CIR, LAS CRUCES, NM 88011-4759
(575) 522-9500
(575) 523-1108
Mailing address
1350 HILLRISE CIR, LAS CRUCES, NM 88011-4759
(575) 522-9500
(575) 523-1108
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4700
NM
Other
Enumeration date
08/06/2010
Last updated
08/06/2010
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