MEDICARE: BRADSHER CONSULTANTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1922506179
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRADSHER CONSULTANTS

Provider Business Mailing Address
First Line	:	5527 TIMBER CREEK LN
Second Line	:
City	:	JONESBORO
State	:	AR
Zip	:	72404-9520
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1020 S MADISON ST
Second Line	:
City	:	JONESBORO
State	:	AR
Zip	:	72401-3565
Country	:	US
Telephone Number	:	870-284-0025
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	EMILEE BRADSHER
Credential	:
Telephone Number	:	870-284-0025

Provider Enumeration Date	:	01/23/2018
Last Update Date	:	01/23/2018

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Directions to “BRADSHER CONSULTANTS ” Practice Location

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