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NPI Code Detail

MEDICARE: VERONICA BRADSHAW LMSW

MEDICARE: VERONICA BRADSHAW LMSW
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
1104100000XSocial Worker26262-MAR
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1063624849
Entity Type Code : Individual
Provider Name (Legal Business Name) : VERONICA BRADSHAW LMSW
Provider Business Mailing Address
First Line : 110 PEARSON
Second Line :
City : BENTON
State : AR
Zip : 72015-4436
Country : US
Telephone Number : 501-315-4224
Fax Number : 501-778-0450
Provider Business Practice Location Address
First Line : 110 PEARSON
Second Line :
City : BENTON
State : AR
Zip : 72015-4436
Country : US
Telephone Number : 501-315-4224
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2007
Last Update Date : 12/19/2024

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Directions to “ VERONICA BRADSHAW LMSW” Practice Location

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