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NPI Code Detail

MEDICARE: MRS. CARSON SHAE BRADSHAW MA, CCC-SLP

MEDICARE: MRS. CARSON SHAE BRADSHAW MA, CCC-SLP
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
1235Z00000XSpeech-Language Pathologist14019NC

General Provider Information

NPI Number : 1023662053
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CARSON SHAE BRADSHAW MA, CCC-SLP
Provider Business Mailing Address
First Line : PO BOX 446
Second Line :
City : ALBEMARLE
State : NC
Zip : 28002-0446
Country : US
Telephone Number : 704-438-8303
Fax Number :
Provider Business Practice Location Address
First Line : 124 E NORTH ST
Second Line :
City : ALBEMARLE
State : NC
Zip : 28001-4048
Country : US
Telephone Number : 704-438-8303
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2019
Last Update Date : 08/07/2023

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Directions to “ MRS. CARSON SHAE BRADSHAW MA, CCC-SLP” Practice Location

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