Individual
CARI S. BRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
628 LAKE ST NE, WISE, VA 24293-7919
(276) 328-8017
Mailing address
628 LAKE ST NE, WISE, VA 24293-7919
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
PGP-0646591
VA
Other
Enumeration date
01/10/2018
Last updated
06/16/2018
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