Individual
CHRISTINE D BRADSHAW EARL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
224 GREAT BRIDGE BLVD, CITY OF CHESAPEAKE TA CHES COMM SERVICE BOARD, CHESAPEAKE, VA 23320-3904
(757) 547-9334
(757) 819-6292
Mailing address
224 GREAT BRIDGE BLVD, CITY OF CHESAPEAKE TA CHES COMM SERVICE BOARD, CHESAPEAKE, VA 23320
(757) 547-9334
(757) 819-6292
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904002173
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033147
VALUE OPTIONS
VA
01
—
176185
ANTHEM TRIGON
VA
01
—
324054
TRICARE
VA
05
—
920225
—
VA
Enumeration date
11/16/2006
Last updated
12/28/2009
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