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1730169012
KEVIN BRADSHAW
PORTSMOUTH, VA
NPI
1730169012
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: TN LSW0000003054)
Enumeration Date
2006-01-20
Last Update Date
2007-07-08
Business Address
-- KEVIN BRADSHAW LCSW
620 JOHN PAUL JONES CIR CODE-1121
PORTSMOUTH, VA 23708-2111
Phone number: 757-953-5861
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Mailing Address
-- KEVIN BRADSHAW LCSW
303 EFFINGHAM ST APT-8-E
PORTSMOUTH, VA 23704-2314
Phone number: 757-362-7774
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