Individual provider · Type 1 NPI
Bradley Shaw
Professional Counselor · Bryant, AR
NPI number
1104229871
Active
Practice location
3708 Robinwood Cir
Bryant, AR 72022-8374
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | P0002005 (AR) |
Professional Counselor: Definition to come...
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About NPI 1104229871
Bradley Shaw's National Provider Identifier is 1104229871, issued on Oct 8, 2014. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Bryant, AR. The record was last updated on Oct 8, 2014.