Individual provider · NPI-1

Stephanie Jene' (Smith) Bradshaw, CCC-SLP

Speech-Language Pathologist, · Joplin, MO

NPI number1013172394
StatusActive
Last updated in NPPESJul 25, 2008

Details

NPI
1013172394
Entity type
Individual (NPI-1)
Name
Mrs. Stephanie Jene' (Smith) Bradshaw
Credential
CCC-SLP
Sex
Female
Sole proprietor
No
Enumeration date
Jul 25, 2008
Last updated
Jul 25, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
235Z00000X Speech-Language Pathologist,2008017253MOYes

Practice location

1102 W 32nd St
Joplin, MO 64804-3503

Phone 417-347-6616

Mailing address

402 Angel Lea
Carl Junction, MO 64834-9329

Phone 417-649-6383

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