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General NPI Number Information
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NPI Number | 1528155538
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Entity Type | Individual
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Provider Name | JULIE BRADSHAW LICSW
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Gender | Female
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 10/28/2008
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Provider Practice Location Address
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Address Line | 8 S MAIN ST STE B
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City | BARRE
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State | VT
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Zip | 05641-4880
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Country | US
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Telephone | 802-479-0050
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Fax | 802-479-0056
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Provider Business Mailing Address
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Address Line | 1189 WHEELER RD
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City | CALAIS
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State | VT
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Zip | 05648-7591
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Country | US
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Telephone | 802-229-4004
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 089-0000944
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License Number State | VT
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