Individual
DANIELLE MCGOVERN BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1101 E HW 54, WOMENS EASTERN RECEPTION DIAGNOSTIC AND CORRECTIONAL CE, VANDALIA, MO 63382
(573) 594-6686
Mailing address
1026 NORTHEAST DR, MHM SERVICES, JEFFERSON CITY, MO 65109
(573) 635-3850
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
2012012825
MO
Other
Enumeration date
07/19/2007
Last updated
07/31/2013
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