Individual
MRS. KIMBERLY SMITH BRADSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2503 BONNIE AVE, BASTROP, LA 71220-4173
(318) 516-4065
Mailing address
2503 BONNIE AVE, BASTROP, LA 71220-4173
(318) 516-4065
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
15704
LA
1041C0700X
Clinical Social Worker
15704
LA
Other
Enumeration date
10/22/2015
Last updated
12/30/2022
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