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NPI Code Detail

MEDICARE: JADE A BRADSHAW

MEDICARE: JADE A BRADSHAW
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1730036773
Entity Type Code : Individual
Provider Name (Legal Business Name) : JADE A BRADSHAW
Provider Business Mailing Address
First Line : 830 TENDERFOOT HILL RD STE 100
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80906-7372
Country : US
Telephone Number : 888-611-0870
Fax Number : 888-714-4996
Provider Business Practice Location Address
First Line : 830 TENDERFOOT HILL RD STE 100
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80906-7372
Country : US
Telephone Number : 888-611-0870
Fax Number : 888-714-4996
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2026
Last Update Date : 03/10/2026

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Directions to “ JADE A BRADSHAW ” Practice Location

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