Individual
STEPHANIE JEANELLE BRADSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED DIETICIAN
Contact information
Practice address
155 CALLE PORTAL STE 700, SIERRA VISTA, AZ 85635-2973
(520) 459-0203
(520) 459-3159
Mailing address
155 CALLE PORTAL STE 100, SIERRA VISTA, AZ 85635-2900
(520) 515-8673
(520) 515-8663
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86071110
AZ
Other
Enumeration date
07/31/2018
Last updated
07/31/2018
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