Individual
MRS. CLINIECE VAUGHT BRADSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTAL
Contact information
Practice address
4975 JM CRAIG RD, GRANITE FALLS, NC 28630-9295
(828) 728-7595
Mailing address
4975 JM CRAIG RD, GRANITE FALLS, NC 28630-9295
(828) 728-7595
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1532
NC
Other
Enumeration date
06/20/2007
Last updated
07/08/2007
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