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Organization

ROSE A BRADSHAW, LCSW, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROSE A BRADSHAW LCSW (PRESIDENT)
(207) 671-0305
Entity
Organization

Contact information

Practice address
40 FOREST FALLS DR STE 3, YARMOUTH, ME 04096-6905
(207) 671-0305
(207) 669-4837
Mailing address
137 MIDDLE RD, CUMBERLAND, ME 04021-3710
(207) 671-0305
(207) 669-4837

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1437239910
ME
Enumeration date
10/30/2018
Last updated
10/30/2018
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